Provider Demographics
NPI:1578659231
Name:CORRY, NICHOLE
Entity Type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:
Last Name:CORRY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:OLEKOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:625 N FLAGLER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-4006
Mailing Address - Country:US
Mailing Address - Phone:561-268-2000
Mailing Address - Fax:561-328-9752
Practice Address - Street 1:625 N FLAGLER DR STE 200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4006
Practice Address - Country:US
Practice Address - Phone:561-268-2000
Practice Address - Fax:561-328-9752
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRT-1557207R00000X
FLME121351207R00000X
CT047931207R00000X
FL121351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine