Provider Demographics
NPI:1922352681
Name:DENNIS, NICOLE DENISE (NP, RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DENISE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:NP, RN, CPNP
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:DENISE
Other - Last Name:DOWNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CPNP
Mailing Address - Street 1:601 E MICHELTORENA ST UNIT 73
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1999
Mailing Address - Country:US
Mailing Address - Phone:321-271-8195
Mailing Address - Fax:
Practice Address - Street 1:510 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4230
Practice Address - Country:US
Practice Address - Phone:805-845-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22448363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics