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General NPI Number Information
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NPI Number | 1144170309
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Entity Type | Individual
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Provider Name | VANESSA BERRAME NICKELL APRN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 23559 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559-6862
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Country | US
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Telephone | 772-530-0010
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Fax | 813-909-1005
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Provider Business Mailing Address
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Address Line | 23559 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559-6862
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Country | US
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Telephone | 772-530-0010
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Fax | 813-909-1005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11045162
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License Number State | FL
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