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General NPI Number Information
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NPI Number | 1275132870
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Entity Type | Individual
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Provider Name | NICOLE ELIZEE DNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone | 954-493-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN813528
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN1101133
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License Number State | FL
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