Healthcare Provider Details

I. General information

NPI: 1023936234
Provider Name (Legal Business Name): NICOLE DEPEW FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 GREENWAY CT
SANFORD NC
27330-6954
US

IV. Provider business mailing address

63 WINDING TRL
WHISPERING PINES NC
28327-6729
US

V. Phone/Fax

Practice location:
  • Phone: 919-292-1201
  • Fax:
Mailing address:
  • Phone: 919-292-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: