Provider Demographics
NPI:1497345458
Name:FOLEY, NICOLE A (WHNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:FOLEY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-7440
Mailing Address - Country:US
Mailing Address - Phone:630-886-6515
Mailing Address - Fax:
Practice Address - Street 1:45 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-5920
Practice Address - Country:US
Practice Address - Phone:860-443-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8759363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health