Healthcare Provider Details

I. General information

NPI: 1477194496
Provider Name (Legal Business Name): NICOLE DENISE ABRAMS WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE DENISE DAVIS WHNP-BC

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SAINT PAUL ST
BALTIMORE MD
21202-2001
US

IV. Provider business mailing address

227 SAINT PAUL ST
BALTIMORE MD
21202-2001
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9330
  • Fax:
Mailing address:
  • Phone: 410-332-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR202861
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR202861
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: