Provider Demographics
NPI:1487164992
Name:NUGENT, NICOLE ELISE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELISE
Last Name:NUGENT
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6967
Mailing Address - Country:US
Mailing Address - Phone:336-890-3200
Mailing Address - Fax:336-890-3290
Practice Address - Street 1:930 3RD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-890-3200
Practice Address - Fax:336-890-3290
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC004426363LW0102X
IL277002811363LW0102X
MN9829363LW0102X
MTNUR-APRN-LIC-198958363LW0102X
NE114495363LW0102X
CT9569363LW0102X
IAF168209363LW0102X
PASP023495363LW0102X
FLAPRN11021192363LW0102X
TX1059436363LW0102X
NY421318363LW0102X
COC-APN.0003860-C-NP363LW0102X
CA95019898363LW0102X
VA0024184722363LW0102X
NC5012575363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health