Nicole Marie Debernardis, RN
Individual provider Active NPI Registered Nurse · Marcy, NY
NPI 1992266944 · NPPES record last updated Mar 30, 2019
Key facts
- NPI
- 1992266944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 703507 (NY)
- Practice address
- 6050 Cavanaugh Rd
Marcy, NY 13403-2411 - Phone
- (315) 534-0730
- NPI assigned
- Mar 30, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 703507 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 703507 | NY | Yes |
Addresses
Primary practice location
6050 Cavanaugh Rd
Marcy, NY 13403-2411
Mailing address
6944 Dix Rd
Rome, NY 13440-8087
Phone (315) 527-5848
Other providers in Marcy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.