Healthcare Provider Details
I. General information
NPI: 1487164992
Provider Name (Legal Business Name): NICOLE ELISE NUGENT WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/10/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3815 E BELL RD STE 3200
PHOENIX AZ
85032-2162
US
IV. Provider business mailing address
930 3RD ST
GREENSBORO NC
27405-6967
US
V. Phone/Fax
- Phone: 855-850-0638
- Fax:
- Phone: 336-890-3200
- Fax: 336-890-3290
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | APRN.CNP.0041885 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 1059436 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | NP500007711 |
| License Number State | DC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | AC004426 |
| License Number State | MD |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 0024184722 |
| License Number State | VA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | AP61403221 |
| License Number State | WA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | RNP304387 |
| License Number State | AZ |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 9569 |
| License Number State | CT |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | APRN11021192 |
| License Number State | FL |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 41865 |
| License Number State | TN |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | NUR-APRN-LIC-198958 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
