Provider Demographics
NPI:1356457329
Name:ARCAND, NICOLE LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LOUISE
Last Name:ARCAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PURGATORY RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-2943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:82 NEW PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH FRANKLIN
Practice Address - State:CT
Practice Address - Zip Code:06254-1807
Practice Address - Country:US
Practice Address - Phone:860-889-7345
Practice Address - Fax:860-823-2940
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00158207X00000X
CT047670207XX0004X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008004043Medicaid
RI76-793OtherBIRTH CERTIFICATE NUMBER
CT008004043Medicaid