Individual
NICOLE KINGSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, SRNA
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3000
Mailing address
60 GRASMERE AVE, FAIRFIELD, CT 06824-6136
(760) 505-3875
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
157532
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157532
STATE OF CT - RN LICENSE
CT
Enumeration date
07/25/2021
Last updated
07/25/2021
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