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Individual

MS. NICOLE WATERHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
61 N MAPLE AVE, SUITE 305, RIDGEWOOD, NJ 07450-3255
(201) 444-2019
Mailing address
26-02 MORLOT AVE, FAIR LAWN, NJ 07410-3111
(201) 873-5614

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00657700
NJ

Other

Enumeration date
08/01/2016
Last updated
08/01/2016
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