Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 005474 | CT |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 991442 | CO |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN2262045 | MA |
NPI | 1013340421 |
---|---|
Provider Name | Nicole Solk |
First Address | Providence, RI 02907-2567 |
Second Address | New Bedford, MA 02740-6728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 29/04/2019 |