MEDICARE: NICOLE BRACCIALE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11039834	CO

General Provider Information

NPI Number	:	1144013293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE BRACCIALE FNP-C

Provider Business Mailing Address
First Line	:	7995 E MISSISSIPPI AVE APT G12
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-6836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4037 NW 86TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-9281
Country	:	US
Telephone Number	:	352-733-0111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	07/19/2025

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