Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 341422 | NY |
NPI | 1003355868 |
---|---|
Provider Name | Mrs. Nicole Michele Cardwell |
First Address | Cortlandt Manor, NY 10567-5135 |
Second Address | White Plains, NY 10605-1440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2017 |
Last Update Date | 05/02/2020 |