Provider Demographics
NPI:1609402106
Name:RALSTON, NICOLE CARIDAD
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:CARIDAD
Last Name:RALSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 BARONNE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1577
Mailing Address - Country:US
Mailing Address - Phone:239-580-8116
Mailing Address - Fax:
Practice Address - Street 1:2004 BARONNE ST APT 3
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1577
Practice Address - Country:US
Practice Address - Phone:239-580-8116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay