Provider Demographics
NPI:1194560045
Name:MULE, NICOLE STEPHANIE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:STEPHANIE
Last Name:MULE
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 1:16428 127TH DR N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-6532
Mailing Address - Country:US
Mailing Address - Phone:561-262-2220
Mailing Address - Fax:
Practice Address - Street 1:6650 W INDIANTOWN RD STE 110
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4629
Practice Address - Country:US
Practice Address - Phone:561-575-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily