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General NPI Number Information
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NPI Number | 1326438599
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Entity Type | Individual
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Provider Name | NICOLE LANGLOIS TIEFEL NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 1180 NEWFIELD AVE
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City | STAMFORD
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State | CT
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Zip | 06905-1409
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Country | US
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Telephone | 314-888-5233
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Fax |
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Provider Business Mailing Address
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Address Line | 5248 OLDE TOWNE RD STE 10
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-1986
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1256167
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24172342
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 123051
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License Number State | AK
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