Individual ProviderNicole ClintonLicensed Practical NurseNursing Service ProvidersPractice Address15 Prospect St W, Amityville, NY 11701-2027(631) 841-1499PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Clinton 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 yesterday at 9:43 AM.Profile DetailsProvider ID1912237603Provider TypeIndividualFull NameClinton, NicoleTitleMrs.CredentialLPNGenderFemaleSole ProprietorNoEnumeration Date1/3/2010Last Updated1/3/2010Contact InformationPractice LocationPractice Address15 Prospect St W, Amityville, NY 11701-2027Phone(631) 841-1499FaxUnlisted FaxMailing LocationMailing Address15 Prospect St W, Amityville, NY 11701-2027Phone(631) 841-1499FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense291865New York