Provider Demographics
NPI:1194324889
Name:TUGGLES, NICHOLE MARIE
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:MARIE
Last Name:TUGGLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DREXEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-5305
Mailing Address - Country:US
Mailing Address - Phone:585-698-3619
Mailing Address - Fax:
Practice Address - Street 1:37 DREXEL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5305
Practice Address - Country:US
Practice Address - Phone:585-698-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672405163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse