Provider Demographics
NPI:1427223221
Name:RULE, NICOLE KRISTIN (APRN, PHD)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KRISTIN
Last Name:RULE
Suffix:
Gender:F
Credentials:APRN, PHD
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:KRISTIN
Other - Last Name:CLINARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3019
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:2000 OSPREY BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4347
Practice Address - Country:US
Practice Address - Phone:863-680-7243
Practice Address - Fax:866-264-8519
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9210776363LX0001X, 363LA2200X
FLARNP9210776363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK318ZMedicare PIN
FL309114700Medicaid