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General NPI Number Information
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NPI Number | 1487034666
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Entity Type | Individual
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Provider Name | NICOLE MONCRIEFFE
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Gender | Female
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 351 W CAMDEN ST
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City | BALTIMORE
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State | MD
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Zip | 21201-7912
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Country | US
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Telephone | 410-625-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 PRESERVE PARK DR
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City | LOGANVILLE
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State | GA
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Zip | 30052-5826
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Country | US
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Telephone | 678-756-2355
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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 | RN181921
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License Number State | GA
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