Healthcare Provider Details

I. General information

NPI: 1164270765
Provider Name (Legal Business Name): NIMRODE NEPHTALIE ARIDOU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date: 10/29/2025
Reactivation Date: 04/22/2026

III. Provider practice location address

6640 WILKINSON BLVD SUITE 450
BELMONT NC
28012
US

IV. Provider business mailing address

6640 WILKINSON BLVD SUITE 450
BELMONT NC
28012
US

V. Phone/Fax

Practice location:
  • Phone: 855-616-0192
  • Fax:
Mailing address:
  • Phone: 561-225-8986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5024266
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number89006
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG190494
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: