Individual
MRS. NICOLE A FAWKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 QUANTUM LAKES DR, BOYNTON BEACH, FL 33426-8334
(561) 859-7954
Mailing address
3080 QUANTUM LAKES DR, BOYNTON BEACH, FL 33426-8334
(561) 859-7954
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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