Provider Demographics
NPI:1376057885
Name:FINCH, NICHOLE (RN)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:FINCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 VAN WYCK EXPY
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2229
Mailing Address - Country:US
Mailing Address - Phone:718-322-3455
Mailing Address - Fax:718-848-4152
Practice Address - Street 1:11440 VAN WYCK EXPY
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2229
Practice Address - Country:US
Practice Address - Phone:718-322-3455
Practice Address - Fax:718-848-4152
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY528253-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse