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NPI Code Detail

MEDICARE: KRISTI REBECCA NICHOLS FNP-BC

MEDICARE: KRISTI REBECCA NICHOLS FNP-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
1363LF0000XFamily Nurse PractitionerLG-0000832DE

General Provider Information

NPI Number : 1841683844
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI REBECCA NICHOLS FNP-BC
Provider Business Mailing Address
First Line : 30549 SUSSEX HWY
Second Line :
City : LAUREL
State : DE
Zip : 19956-3891
Country : US
Telephone Number : 302-715-5214
Fax Number :
Provider Business Practice Location Address
First Line : 30549 SUSSEX HWY
Second Line :
City : LAUREL
State : DE
Zip : 19956-3891
Country : US
Telephone Number : 302-715-5214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2015
Last Update Date : 02/22/2017

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Directions to “ KRISTI REBECCA NICHOLS FNP-BC” Practice Location

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