Healthcare Provider Details

I. General information

NPI: 1285562157
Provider Name (Legal Business Name): NICKI SPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 BEDFORD AVE
BROOKLYN NY
11205-5632
US

IV. Provider business mailing address

19726 CARPENTER AVE
HOLLIS NY
11423-2959
US

V. Phone/Fax

Practice location:
  • Phone: 347-927-1172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: NICOLE JONES
Title or Position: TRICHOLOGIST/CEO
Credential:
Phone: 718-809-7603