Healthcare Provider Details

I. General information

NPI: 1306706916
Provider Name (Legal Business Name): NICHOLE SZATKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2025
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LAKE AVE
WORCESTER MA
01604-1168
US

IV. Provider business mailing address

307 TRENT DR
DURHAM NC
27710-3038
US

V. Phone/Fax

Practice location:
  • Phone: 857-200-6436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN2335791
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: