Provider Demographics
NPI:1518134113
Name:PALUMBO, NICOLE P (RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:P
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:NARDELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-3038
Mailing Address - Fax:617-730-0477
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-3038
Practice Address - Fax:617-730-0477
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMN1471375363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics