Healthcare Provider Details

I. General information

NPI: 1114871373
Provider Name (Legal Business Name): DR NICHOLAS DAMICO DNP AGNP C PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 KILDAIRE FARM RD STE 307
CARY NC
27511-7600
US

IV. Provider business mailing address

1140 KILDAIRE FARM RD STE 307
CARY NC
27511-7600
US

V. Phone/Fax

Practice location:
  • Phone: 984-299-3377
  • Fax: 801-630-9324
Mailing address:
  • Phone:
  • Fax: 801-630-9324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS LOUIS D'AMICO
Title or Position: OWNER
Credential: DNP AGNP-C
Phone: 919-800-7274