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General NPI Number Information
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NPI Number | 1154235612
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Entity Type | Organization
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Legal Business Name | NICK THE NP, LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 6 MAIN AVE SW
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3863
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Country | US
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Telephone | 657-307-8727
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Fax |
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Provider Business Mailing Address
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Address Line | 6 MAIN AVE SW
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3863
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Country | US
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Telephone | 657-307-8727
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Fax |
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Authorized Official
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Title or Position | OWNER/FNP
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Name | MR. NICHOLAS WOLF
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Credential | FNP-BC
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Telephone | 657-307-8727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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