Healthcare Provider Details

I. General information

NPI: 1265193882
Provider Name (Legal Business Name): NICOLE ELIZABETH WROBEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

IV. Provider business mailing address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-5472
  • Fax: 603-356-9647
Mailing address:
  • Phone: 603-356-5472
  • Fax: 603-356-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number075995-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: