Healthcare Provider Details

I. General information

NPI: 1841120748
Provider Name (Legal Business Name): NICOLE CHEREE DORAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE CHEREE WILLIAMS

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 ALT 19
PALM HARBOR FL
34683-1412
US

IV. Provider business mailing address

1555 PICARDY CIR
CLEARWATER FL
33755-1626
US

V. Phone/Fax

Practice location:
  • Phone: 727-732-4305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11046488
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: