Healthcare Provider Details

I. General information

NPI: 1932013299
Provider Name (Legal Business Name): NICOLE ROSELLA HARRIS-HOLLINGSWORTH EDD, MCHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WELLBROOK PL FL 6
ISELIN NJ
08830-1559
US

IV. Provider business mailing address

1 WELLBROOK PL FL 6
ISELIN NJ
08830-1559
US

V. Phone/Fax

Practice location:
  • Phone: 848-888-4316
  • Fax:
Mailing address:
  • Phone: 848-888-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: