Provider Demographics
NPI:1295032514
Name:PALADINO, NICHOLE DIANA (APN)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:DIANA
Last Name:PALADINO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 HOGAN LN STE 1
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8498
Mailing Address - Country:US
Mailing Address - Phone:501-327-1150
Mailing Address - Fax:501-327-3427
Practice Address - Street 1:495 HOGAN LN STE 1
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8498
Practice Address - Country:US
Practice Address - Phone:501-327-1150
Practice Address - Fax:501-327-3427
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03486 ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily