Provider Demographics
NPI:1114284072
Name:UNA, NICOLE S (NP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:S
Last Name:UNA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ELLIS ST FL 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2735
Mailing Address - Country:US
Mailing Address - Phone:415-674-6140
Mailing Address - Fax:415-568-2094
Practice Address - Street 1:330 ELLIS ST FL 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2735
Practice Address - Country:US
Practice Address - Phone:415-674-6140
Practice Address - Fax:415-568-2094
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21037363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health