Canterella, Nicole D

Canterella, Nicole D is an sole proprietor health care provider with primary practice located at 2222 Colonial Rd Ste 100 , Fort Pierce FL 34950-5309. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Canterella, Nicole D can be contacted via phone (772) 489-4726.

Contact Information

Primary practice address
2222 Colonial Rd Ste 100 Fort Pierce FL 34950-5309
Phone: (772) 489-4726
Fax: (772) 466-5578
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2157992 Florida

Profile Details

NPI number 1508014762
LBN Legal business name Canterella, Nicole D
Credentials PMHNP, BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2008
Last updated Nov 22nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508014762 NPPES
Florida MEDICAID 306269400

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