Healthcare Provider Details

I. General information

NPI: 1891618229
Provider Name (Legal Business Name): NICOLE BILODEAU FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 ATLANTA HWY
WARRENTON GA
30828-9109
US

IV. Provider business mailing address

PO BOX 371
WRIGHTSVILLE GA
31096-0371
US

V. Phone/Fax

Practice location:
  • Phone: 478-290-1374
  • Fax: 478-864-1288
Mailing address:
  • Phone: 478-290-1374
  • Fax: 478-864-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number320999
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: