Provider Demographics
NPI:1063892669
Name:NOEL, NAKITTA (MD)
Entity type:Individual
Prefix:MISS
First Name:NAKITTA
Middle Name:
Last Name:NOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 CHALKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4728
Mailing Address - Country:US
Mailing Address - Phone:401-456-2000
Mailing Address - Fax:401-456-2120
Practice Address - Street 1:825 CHALKSTONE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4728
Practice Address - Country:US
Practice Address - Phone:401-456-2000
Practice Address - Fax:401-456-2120
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-04-19
Deactivation Date:2016-01-20
Deactivation Code:
Reactivation Date:2016-02-18
Provider Licenses
StateLicense IDTaxonomies
390200000X
RIDO084917207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program