Healthcare Provider Details

I. General information

NPI: 1760289375
Provider Name (Legal Business Name): NICOLE ORBAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 TECHNOLOGY DR UNIT A100
TRUMBULL CT
06611-6341
US

IV. Provider business mailing address

35 SULIK TER
STRATFORD CT
06614-3146
US

V. Phone/Fax

Practice location:
  • Phone: 203-880-5556
  • Fax:
Mailing address:
  • Phone: 413-441-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number152434
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number16422
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: