Provider Demographics
NPI:1467893321
Name:DINEZZA, NICOLE M (DC, NTP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:DINEZZA
Suffix:
Gender:F
Credentials:DC, NTP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:CYR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1289 N FORDHAM BLVD
Mailing Address - Street 2:STE E3
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-238-4094
Mailing Address - Fax:919-205-4369
Practice Address - Street 1:1289 N FORDHAM BLVD
Practice Address - Street 2:STE E3
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-238-4094
Practice Address - Fax:919-205-4369
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4361111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor