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NPI Code Detail

MEDICARE: MS. CATHERINE DELITA NICHOLSON PMHNP-BC

MEDICARE: MS. CATHERINE DELITA NICHOLSON PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner883883NV

General Provider Information

NPI Number : 1679393912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE DELITA NICHOLSON PMHNP-BC
Provider Business Mailing Address
First Line : PO BOX 335454
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89033-5454
Country : US
Telephone Number : 504-919-0939
Fax Number :
Provider Business Practice Location Address
First Line : 5550 PAINTED MIRAGE RD STE 320
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4584
Country : US
Telephone Number : 725-242-4793
Fax Number : 725-241-4870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2024
Last Update Date : 04/17/2026

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