Provider Demographics
NPI:1740903939
Name:ARMENTA, NICOLE MARIE (BSN, RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:ARMENTA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE RICHTER
Other - Last Name:SPRAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4041 S MCCLINTOCK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5879
Mailing Address - Country:US
Mailing Address - Phone:520-233-7111
Mailing Address - Fax:602-357-4604
Practice Address - Street 1:4041 S MCCLINTOCK DR STE 302
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5879
Practice Address - Country:US
Practice Address - Phone:520-233-7111
Practice Address - Fax:602-357-4604
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN207859163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management