Provider Demographics
NPI:1396548491
Name:VASCIMINI, NICOLE LEE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LEE
Last Name:VASCIMINI
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 1:129 JOHN GREEN PL APT 309
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-3735
Mailing Address - Country:US
Mailing Address - Phone:615-717-2160
Mailing Address - Fax:
Practice Address - Street 1:39 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOLDENS BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:10526-1211
Practice Address - Country:US
Practice Address - Phone:615-717-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY874335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse