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General NPI Number Information
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NPI Number | 1407311632
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Entity Type | Individual
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Provider Name | RICHAELE ROSE NICHIPORENKO DNP, ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 5901 BROKEN SOUND PKWY NW STE 600
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City | BOCA RATON
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State | FL
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Zip | 33487-2784
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Country | US
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Telephone | 561-982-2900
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Fax | 561-982-2901
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Provider Business Mailing Address
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Address Line | 5901 BROKEN SOUND PKWY NW STE 600
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City | BOCA RATON
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State | FL
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Zip | 33487-2784
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Country | US
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Telephone | 561-982-2900
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Fax | 561-892-0227
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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 | 9273317
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License Number State | FL
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