Nicollette A Thetford, LPN
Licensed Practical Nurse in Brooklyn, NY. Individual provider (NPI-1).
NPI number1013201367
StatusActive
Last updated in NPPESJun 3, 2011
Details
- NPI
- 1013201367
- Entity type
- Individual (NPI-1)
- Name
- Miss Nicollette A Thetford
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2011
- Last updated
- Jun 3, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 303236 | NY | Yes |
Practice location
973 E 80th StBrooklyn, NY 11236-3809
Phone 516-528-9589
Mailing address
973 E 80th StBrooklyn, NY 11236-3809
Phone 516-528-9589
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