Individual ProviderNichole Marie FieldsSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address92 7th Ave, Apt. 6, Brooklyn, NY 11217-3650(618) 830-4623PECOS EnrollmentBased on the most recent information from CMS, provider Nichole Marie Fields does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1730318189Provider TypeIndividualFull NameFields, Nichole MarieGenderFemaleSole ProprietorYesEnumeration Date7/7/2009Last Updated2/15/2017Contact InformationPractice LocationPractice Address92 7th Ave, Apt. 6, Brooklyn, NY 11217-3650Phone(618) 830-4623FaxUnlisted FaxMailing LocationMailing Address92 7th Ave, Apt. 6, Brooklyn, NY 11217-3650Phone(618) 830-4623FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense025348New YorkCode235Z00000XDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense146.010878Illinois