Healthcare Provider Details

I. General information

NPI: 1871997361
Provider Name (Legal Business Name): NICHELLE NICOLE DIGGS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7925 WINCHESTER BLVD
QUEENS VILLAGE NY
11427-2128
US

IV. Provider business mailing address

PO BOX 120325
SAINT ALBANS NY
11412-0325
US

V. Phone/Fax

Practice location:
  • Phone: 718-264-4063
  • Fax:
Mailing address:
  • Phone: 917-977-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354292
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number690406
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: