Healthcare Provider Details

I. General information

NPI: 1255942033
Provider Name (Legal Business Name): AMANI NICOL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 REISTERSTOWN RD STE 220
PIKESVILLE MD
21208-2987
US

IV. Provider business mailing address

731 CLOUDYFOLD DR
PIKESVILLE MD
21208-4608
US

V. Phone/Fax

Practice location:
  • Phone: 443-898-6562
  • Fax: 410-648-9712
Mailing address:
  • Phone: 443-813-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number StateNULL

VIII. Authorized Official

Name: NIKIA DENISE SWEENEY
Title or Position: WELLNESS DIRECTOR
Credential: NBHWC
Phone: 443-898-6562