Healthcare Provider Details

I. General information

NPI: 1538015409
Provider Name (Legal Business Name): NICOLAI WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 MINNESOTA AVE NE
WASHINGTON DC
20019-2662
US

IV. Provider business mailing address

5861 TOSCANA DR APT 1437
DAVIE FL
33314-3576
US

V. Phone/Fax

Practice location:
  • Phone: 202-396-1444
  • Fax:
Mailing address:
  • Phone: 239-319-7177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: