MEDICARE: NICOLE DUNKLE

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	163W00000X	Registered Nurse	594665-1	NY

General Provider Information

NPI Number	:	1215265210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE DUNKLE

Provider Business Mailing Address
First Line	:	3270 SENECA ST
Second Line	:	APT. 7
City	:	WEST SENECA
State	:	NY
Zip	:	14224-2759
Country	:	US
Telephone Number	:	716-444-3197
Fax Number	:

Provider Business Practice Location Address
First Line	:	3270 SENECA ST
Second Line	:	APT. 7
City	:	WEST SENECA
State	:	NY
Zip	:	14224-2759
Country	:	US
Telephone Number	:	716-444-3197
Fax Number	:

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

Provider Enumeration Date	:	12/02/2009
Last Update Date	:	12/02/2009

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Directions to “ NICOLE DUNKLE ” Practice Location

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