Mailloux, Nichole M

Mailloux, Nichole M is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mailloux, Nichole M can be contacted via phone (508) 334-3452.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 334-3452
Fax: (508) 334-7284
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 003481 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN216625 Massachusetts

Profile Details

NPI number 1417098898
LBN Legal business name Mailloux, Nichole M
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2007
Last updated Nov 4th, 2020 - about 4 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 1417098898 NPPES
Connecticut MEDICAID 004034815
Connecticut MEDICAID Q76688

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