Individual
NICOLE DANIELLE MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3949 CORRALES RD STE 105, CORRALES, NM 87048-9347
(949) 820-1743
(847) 221-6782
Mailing address
2318 GARDEN RD NE, RIO RANCHO, NM 87124-2431
(505) 459-4602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
82459
NM
Other
Enumeration date
01/22/2025
Last updated
04/30/2026
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