Healthcare Provider Details

I. General information

NPI: 1457232027
Provider Name (Legal Business Name): NICHOLE RAMBARAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 W 17TH ST APT C204
PANAMA CITY FL
32405-3110
US

IV. Provider business mailing address

1722 W 17TH ST APT C204
PANAMA CITY FL
32405-3110
US

V. Phone/Fax

Practice location:
  • Phone: 448-205-0360
  • Fax:
Mailing address:
  • Phone: 448-205-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: