Provider Demographics
NPI:1467815316
Name:NICOLETTA, KAROLE (RN)
Entity Type:Individual
Prefix:
First Name:KAROLE
Middle Name:
Last Name:NICOLETTA
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 1:328 EDWARDS AVE
Mailing Address - Street 2:
Mailing Address - City:CHESILHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-1134
Mailing Address - Country:US
Mailing Address - Phone:856-723-2326
Mailing Address - Fax:
Practice Address - Street 1:328 EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:CHESILHURST
Practice Address - State:NJ
Practice Address - Zip Code:08089-1134
Practice Address - Country:US
Practice Address - Phone:856-723-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07967300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse