Individual
NICOLE KNUDSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
82 TURKEY LN, COLD SPRING HARBOR, NY 11724-1703
(631) 367-6904
Mailing address
10 CARRINGTON DR, EAST NORTHPORT, NY 11731-3005
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
755566
NY
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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