Individual
MRS. NICOLE D CANTERELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP, BC
Contact information
Practice address
130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
(772) 773-0229
(772) 272-8600
Mailing address
130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
(772) 773-0229
(772) 272-8600
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2157992
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306269400
—
FL
Enumeration date
08/29/2008
Last updated
05/05/2025
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