Individual
MRS. NICHOLE LYNN PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
23415 THREE NOTCH RD, SUITE 2054 WILDWOOD CENTER, CALIFORNIA, MD 20619-4017
(301) 737-7833
(301) 737-4865
Mailing address
PO BOX 189, HOLLYWOOD, MD 20636-0189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R162889
MD
Other
Enumeration date
11/02/2006
Last updated
11/10/2010
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