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NPI Code Detail

MEDICARE: DR. NICOLE MARIE STAMAN D.M.D.

MEDICARE:  DR. NICOLE MARIE STAMAN  D.M.D.
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
1122300000XDentistDN18657FL

General Provider Information

NPI Number : 1427284165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE MARIE STAMAN D.M.D.
Provider Business Mailing Address
First Line : 1401 RIVERPLACE BLVD
Second Line : #911
City : JACKSONVILLE
State : FL
Zip : 32207-9069
Country : US
Telephone Number : 904-238-1021
Fax Number :
Provider Business Practice Location Address
First Line : 1400 ANNUNCIATION ST
Second Line : APT #1203
City : NEW ORLEANS
State : LA
Zip : 70130-8646
Country : US
Telephone Number : 813-476-5774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2009
Last Update Date : 11/05/2013

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Directions to “ DR. NICOLE MARIE STAMAN D.M.D.” Practice Location

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