Individual
MISS LAURENA MARIE NICOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2312742
MA
363LF0000X
Family Nurse Practitioner
Primary
2312742
MA
Other
Enumeration date
08/21/2018
Last updated
12/17/2024
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