Provider Demographics
NPI:1750369500
Name:CIFFONE, NICOLE A (NP)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:A
Last Name:CIFFONE
Suffix:
Gender:
Credentials:NP
Other - Prefix:MR
Other - First Name:NICOLE
Other - Middle Name:A
Other - Last Name:GASTELUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1860 E RIVER RD STE 325-200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5993
Mailing Address - Country:US
Mailing Address - Phone:520-214-0110
Mailing Address - Fax:866-928-4197
Practice Address - Street 1:1860 E RIVER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5993
Practice Address - Country:US
Practice Address - Phone:520-214-0110
Practice Address - Fax:866-928-4197
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN090704363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ832536Medicaid
P50438Medicare UPIN
AZZ111897Medicare PIN
AZZ68377Medicare PIN
AZ832536Medicaid