Provider Demographics
NPI:1023328721
Name:ALFREUS, NICOLE (ARNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ALFREUS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:ALFREUS-JOSEPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1271 SW 44TH TER
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8263
Mailing Address - Country:US
Mailing Address - Phone:786-556-1930
Mailing Address - Fax:
Practice Address - Street 1:6200 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3230
Practice Address - Country:US
Practice Address - Phone:561-997-8991
Practice Address - Fax:561-997-8927
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3371292363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner