MEDICARE: NICOLE PATERNO

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	205972	NC

General Provider Information

NPI Number	:	1881835742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE PATERNO

Provider Business Mailing Address
First Line	:	321 STONE HEDGE CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8640
Country	:	US
Telephone Number	:	919-413-0252
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 STONE HEDGE CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8640
Country	:	US
Telephone Number	:	919-413-0252
Fax Number	:

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

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	03/23/2009

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Directions to “ NICOLE PATERNO ” Practice Location

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