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NICOLE WYNNE
NPI 1164967105
Student in an Organized Health Care Education/Training Program in Medford, MA

Active since December 29, 2016
120 MURRAY ST, MEDFORD, MA 02155(781) 391-0800 Get Directions Write a Review

NPPES record last updated: December 29, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicole Wynne NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE WYNNE (NPI 1164967105) is an individual student in an organized health care education/training program in Medford, Massachusetts and active in the NPI registry since December 2016.

NPPES Registry Identity

NPI1164967105
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameNICOLE WYNNE
Location Address120 MURRAY STMedford, MA 02155-1300
Mailing Address92 Litchfield LnHanson, MA 02341-1011 · (781) 724-2201
Phone(781) 391-0800
Sole ProprietorNo
Enumeration DateDecember 29, 2016
✔ NPI 1164967105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
120 MURRAY ST, Medford, MA 02155
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Other Identifiers 4

Medicare OSCAR/certification390200000XMA
Medicare PIN390200000XMA
Medicaid390200000XMA
Medicare UPIN390200000XMA

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON MARIE SMITH
Physical Therapy Assistant
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800
JASMINE JEAN OTR/L
Occupational Therapist
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800
VICTORIA DIAMOND M.S., CF-SLP
Student in an Organized Health Care Education/Training Program
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (603) 321-2021
MRS. ANNEMARIE HALPIN COTA
Occupational Therapy Assistant
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800
MS. ASHLEY BOVARNICK COTA/L
Occupational Therapy Assistant
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800
MISS MELISSA NICOLE POTHIER COTA/L
Occupational Therapy Assistant
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 931-0800
MR. AARON MICHAEL LEWIS CPTA
Physical Therapy Assistant
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800
AMY MAHER FECK
Physical Therapist
120 MURRAY ST
MEDFORD, MA 02155
Middlesex County (781) 391-0800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Wynne's NPI number?

The NPI number for Nicole Wynne is 1164967105. It was assigned to this individual provider in the NPPES registry on December 29, 2016.

Where is Nicole Wynne located?

Nicole Wynne practices at 120 Murray St, Medford, MA 02155. The listed phone number is (781) 391-0800.

What is Nicole Wynne's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Nicole Wynne was last updated on December 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.