Healthcare Provider Details

I. General information

NPI: 1265202485
Provider Name (Legal Business Name): NIKOLE MICHELLE MIHILL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2267 WOLF ST
VIRGINIA BEACH VA
23454-4444
US

IV. Provider business mailing address

2267 WOLF ST
VIRGINIA BEACH VA
23454-4444
US

V. Phone/Fax

Practice location:
  • Phone: 518-420-6936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001274988
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024195433
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: