Provider Demographics
NPI:1679298350
Name:GERGENTI, NICOLE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:GERGENTI
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6686 KESTREL CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1365
Mailing Address - Country:US
Mailing Address - Phone:239-677-5737
Mailing Address - Fax:
Practice Address - Street 1:2180 IMMOKALEE RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1422
Practice Address - Country:US
Practice Address - Phone:239-514-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily