Individual
MRS. NICOLE MARIE GARDELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
909 N MAIN ST, PROVIDENCE, RI 02904-5752
(401) 273-4064
(401) 273-1268
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 537-7241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN00256
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639313810
—
RI
01
—
709004048
MEDICARE GROUP PTAN
RI
Enumeration date
05/01/2009
Last updated
05/15/2024
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