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NPI Code Detail

MEDICARE: NICOLE VINCENT

MEDICARE: NICOLE VINCENT
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
1363LG0600XGerontology Nurse PractitionerARNP9294061FL
2363LP0808XPsychiatric/Mental Health Nurse Practitioner25653SC
3363LA2100XAcute Care Nurse PractitionerARNP9294061FL

General Provider Information

NPI Number : 1962924530
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE VINCENT
Provider Business Mailing Address
First Line : 455 LAKESHORE PKWY
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-4205
Country : US
Telephone Number : 803-909-6363
Fax Number : 803-909-6390
Provider Business Practice Location Address
First Line : 455 LAKESHORE PKWY
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-4205
Country : US
Telephone Number : 803-909-6363
Fax Number : 803-909-6390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2017
Last Update Date : 05/27/2026

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Directions to “ NICOLE VINCENT ” Practice Location

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