Provider Demographics
NPI:1962477265
Name:TAURGRASSO, NICOLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:TAURGRASSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 BEATTIE AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5023
Mailing Address - Country:US
Mailing Address - Phone:716-478-4800
Mailing Address - Fax:
Practice Address - Street 1:130 BEATTIE AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-478-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
NY674359-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other