Healthcare Provider Details

I. General information

NPI: 1427828235
Provider Name (Legal Business Name): NICOLE AMINMENTSE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 W MAIN ST
HOPKINTON MA
01748-1684
US

IV. Provider business mailing address

77 W MAIN ST
HOPKINTON MA
01748-1684
US

V. Phone/Fax

Practice location:
  • Phone: 508-435-5506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: