MRS. NICOLE POLBOS ARNP NPI 1174063127

NPI Information

  • NPI: 1174063127
  • Provider Name: MRS. NICOLE POLBOS, ARNP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1283 SW STATE ROAD 47
    SUITE 104
    LAKE CITY, FL
    ZIP 32025
  • Phone: (386) 758-5985

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NPI Details

MRS. Nicole Polbos, ARNP is a primary care nurse practitioner in Lake City, FL. MRS. Nicole Polbos, ARNP NPI is 1174063127. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1283 SW STATE ROAD 47
SUITE 104
LAKE CITY, FL
ZIP 32025-489
Phone: (386) 758-5985

The NPI 1174063127 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/24/2017 and was last updated on 2/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareARNP 9265534FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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