Healthcare Provider Details

I. General information

NPI: 1750316261
Provider Name (Legal Business Name): NICOLETTE CHRISTIE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 01/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 US HIGHWAY 1
JUNO BEACH FL
33408-1402
US

IV. Provider business mailing address

1055 SW BLUE WATER WAY
STUART FL
34997-7456
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-3240
  • Fax:
Mailing address:
  • Phone: 772-220-3456
  • Fax: 772-220-3014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP9216598
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9216598
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARRP9216598
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: