Provider Demographics
NPI:1598035479
Name:PAULSON, NICOLE J (PA-C)
Entity type:Individual
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First Name:NICOLE
Middle Name:J
Last Name:PAULSON
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Gender:
Credentials:PA-C
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 BELMONT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:774-776-2991
Practice Address - Fax:747-776-2996
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2025-03-11
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant