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General NPI Number Information
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NPI Number | 1881130920
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Entity Type | Individual
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Provider Name | NICOLE CAVALIERE CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 111 S 11TH ST STE G8490
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-955-1120
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Fax |
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Provider Business Mailing Address
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Address Line | 111 S 11TH ST STE G8490
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-1120
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Fax | 215-955-2420
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP016922
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License Number State | PA
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