MEDICARE: NICOLE LAUREN CONDE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-26-525767	FL

General Provider Information

NPI Number	:	1255028163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE LAUREN CONDE RN

Provider Business Mailing Address
First Line	:	1328 NYLIC ST # 1
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-2136
Country	:	US
Telephone Number	:	229-264-7884
Fax Number	:

Provider Business Practice Location Address
First Line	:	2928 WELLINGTON CIR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-6887
Country	:	US
Telephone Number	:	850-521-0242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	03/31/2026

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Directions to “ NICOLE LAUREN CONDE RN” Practice Location

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