Provider Demographics
NPI:1295529014
Name:TROUPE, NICOLE R
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:R
Last Name:TROUPE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 KENNESBOROUGH RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1189
Mailing Address - Country:US
Mailing Address - Phone:813-546-4509
Mailing Address - Fax:
Practice Address - Street 1:3504 COASTAL DUSK DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33565-5943
Practice Address - Country:US
Practice Address - Phone:813-546-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232910587Z251E00000X
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health