Individual
MISS NICOLETTE DIANE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-9564
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 305-9564
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F-302394-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
302394
NY
Other
Enumeration date
01/22/2008
Last updated
04/13/2020
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