Provider Demographics
NPI:1184321150
Name:RAMOS, NICOLE DEMETRA (FNP-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:DEMETRA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 WAITSFIELD DR N
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9307
Mailing Address - Country:US
Mailing Address - Phone:315-412-6674
Mailing Address - Fax:
Practice Address - Street 1:321 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3201
Practice Address - Country:US
Practice Address - Phone:315-703-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11602163W00000X
OH445222163W00000X
NY350731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse