Provider Demographics
NPI:1801171632
Name:GEORGE, NICOLE M (FNP)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:M
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 ALTAMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-1039
Mailing Address - Country:US
Mailing Address - Phone:518-469-4890
Mailing Address - Fax:518-346-7512
Practice Address - Street 1:526 ALTAMONT AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1039
Practice Address - Country:US
Practice Address - Phone:518-469-4890
Practice Address - Fax:518-346-7512
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336820363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily