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General NPI Number Information
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NPI Number | 1366866485
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Entity Type | Individual
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Provider Name | NICOLE M. LAVIN APRN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 11/06/2021
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Provider Practice Location Address
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Address Line | 1 W SAMPLE ROAD
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City | POMPANO BEACH
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State | FL
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Zip | 33064
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Country | US
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Telephone | 854-204-5949
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 NW 38TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2830
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Country | US
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Telephone | 954-464-1694
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 363L00000X
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9309250
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License Number State | FL
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