Provider Demographics
NPI:1376107839
Name:BOCK, NICOLE MARIE (DNP, APN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MARIE
Last Name:BOCK
Suffix:
Gender:F
Credentials:DNP, APN, FNP-C
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:KORDZIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APN, FNP-C
Mailing Address - Street 1:10680 MEDLOCK BRIDGE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8420
Mailing Address - Country:US
Mailing Address - Phone:725-209-3053
Mailing Address - Fax:855-927-7788
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN RD STE E
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1400
Practice Address - Country:US
Practice Address - Phone:725-209-3053
Practice Address - Fax:855-927-7788
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00927200363LF0000X
NJ26NR18161900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse