Provider Demographics
NPI:1962086553
Name:DENUCCIO, NICOLE LYNN (RN, CNM)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:DENUCCIO
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LINDEN ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-3783
Mailing Address - Country:US
Mailing Address - Phone:650-743-4900
Mailing Address - Fax:
Practice Address - Street 1:36 LINDEN ST APT 3C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-3783
Practice Address - Country:US
Practice Address - Phone:650-743-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002082176B00000X
NY722749163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient