Provider Demographics
NPI:1124831268
Name:ELVINA, NICOLE LYNN (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:ELVINA
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 APPLEGARTH RD
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3821
Mailing Address - Country:US
Mailing Address - Phone:609-964-7316
Mailing Address - Fax:
Practice Address - Street 1:298 APPLEGARTH RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3821
Practice Address - Country:US
Practice Address - Phone:609-964-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15213800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily