Provider Demographics
NPI:1790327062
Name:GUERRIER, NICOLETTA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:
Last Name:GUERRIER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:NICOLETTA
Other - Middle Name:
Other - Last Name:GUERRIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:2366 DUTCH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3508
Mailing Address - Country:US
Mailing Address - Phone:516-488-8595
Mailing Address - Fax:516-488-8599
Practice Address - Street 1:2366 DUTCH BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3508
Practice Address - Country:US
Practice Address - Phone:516-488-8595
Practice Address - Fax:516-488-8599
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5955951163WC0400X
NYF311312-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty