MEDICARE: NICOLE ERINN SAINWORLA

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	171M00000X	Case Manager/Care Coordinator		NC

General Provider Information

NPI Number	:	1336003334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ERINN SAINWORLA

Provider Business Mailing Address
First Line	:	1112 GOLDEN CREST DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-9520
Country	:	US
Telephone Number	:	910-308-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 GOLDEN CREST DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-9520
Country	:	US
Telephone Number	:	910-308-1935
Fax Number	:

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

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	12/13/2025

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