Provider Demographics
NPI:1669177374
Name:PRINTON, NICOLE (CNTM)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:PRINTON
Suffix:
Gender:F
Credentials:CNTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHAMPLAIN WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1722
Mailing Address - Country:US
Mailing Address - Phone:848-391-9115
Mailing Address - Fax:
Practice Address - Street 1:30 CHAMPLAIN WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1722
Practice Address - Country:US
Practice Address - Phone:848-391-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach