Provider Demographics
NPI:1356097273
Name:STONE, NICOLE (NRCPT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:NRCPT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMT
Mailing Address - Street 1:1882 VIA SOFIA
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8260
Mailing Address - Country:US
Mailing Address - Phone:561-693-9511
Mailing Address - Fax:
Practice Address - Street 1:1882 VIA SOFIA
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8260
Practice Address - Country:US
Practice Address - Phone:561-693-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL516569146N00000X
FL246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic