Provider Demographics
NPI:1336479534
Name:LEMOINE, NICOLE C (RN,MSN,CNN,FNP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:C
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:RN,MSN,CNN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 MARCUS AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1017
Mailing Address - Country:US
Mailing Address - Phone:516-775-4545
Mailing Address - Fax:516-775-4646
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1017
Practice Address - Country:US
Practice Address - Phone:516-775-4545
Practice Address - Fax:516-775-4646
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333213-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner