Provider Demographics
NPI:1134683022
Name:FERREIRA, NICHOLE S (APRN)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:S
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:FERREIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:459 EDISON RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4317
Mailing Address - Country:US
Mailing Address - Phone:267-987-4339
Mailing Address - Fax:
Practice Address - Street 1:75 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6098
Practice Address - Country:US
Practice Address - Phone:203-869-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7957363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care