Healthcare Provider Details

I. General information

NPI: 1982913000
Provider Name (Legal Business Name): LETICIA ALEJANDRO NICHOLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LETICIA ALEJANDRO

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 FOOTHILLS DRIVE BUILDING D
MORGANTON NC
28655-4044
US

IV. Provider business mailing address

2201 S STERLING ST
MORGANTON NC
28655-4044
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-5380
  • Fax: 828-580-5838
Mailing address:
  • Phone: 828-580-5380
  • Fax: 828-580-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number212381
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number212381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: