Dr NICOLE ELIZABETH AUTHELET is a female medical professional, specializing in Physician Assistant. She graduated in 2017.
LIFESPAN PHYSICIAN GROUP, INC.
185 HIGH SERVICE AVE
NORTH PROVIDENCE
RI
029045114
Tel: 4013546050
| Npi | 1487174447 |
| Pac Id | 3375809650 |
| Professional Enrollment Id | I20171102003342 |
| Last Name | AUTHELET |
| First Name | NICOLE |
| Middle Name | ELIZABETH |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Secondary Specialty 1 | |
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| Organization Legal Name | LIFESPAN PHYSICIAN GROUP, INC. |
| Group Practice Pac Id | 2567455082 |
| Number Of Group Practice Members | 615 |
| Line 1 Street Address | 185 HIGH SERVICE AVE |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | NORTH PROVIDENCE |
| State | RI |
| Zip Code | 029045114 |
| Phone Number | 4013546050 |
| Hospital Affiliation Ccn 1 | 410012 |
| Hospital Affiliation Lbn 1 | THE MIRIAM HOSPITAL |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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