Healthcare Provider Details

I. General information

NPI: 1366367914
Provider Name (Legal Business Name): NICOLE NOEL PATRICK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 ROBINSON ST
BINGHAMTON NY
13904-1775
US

IV. Provider business mailing address

29 MARGARET ST
BINGHAMTON NY
13905-3212
US

V. Phone/Fax

Practice location:
  • Phone: 607-773-4422
  • Fax:
Mailing address:
  • Phone: 607-658-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN38505
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: