Nicole Provenzano, AGACNP-BC
Nicole Provenzano, AGACNP-BC is a Nurse Practitioner in New York, New York. Qualified in 2024, 2 years ago. Licensed in New York.
- Years since qualifying
- 2
- Licensed in
- NY
- In the registry since
- 2025
Practice location Address checks out
1275 York AveNew York, NY 10065-6007
Phone: (212) 639-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Acute Care Nurse Practitioner (primary) | Taxonomy 363LA2100X · Licence 433222 (NY) |
|---|
Record details
| NPI number | 1265395313 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | AGACNP-BC |
| Sole proprietor | No |
| NPI enumerated | December 5, 2025 |
| Last updated in NPPES | January 6, 2026 |
| Certification date | January 6, 2026 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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