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General NPI Number Information
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NPI Number | 1619362837
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Entity Type | Individual
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Provider Name | EMILY NICOLI CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 99 NOTTINGHAM PL
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8429
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Country | US
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Telephone | 443-529-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 99 NOTTINGHAM PL
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8429
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Country | US
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Telephone | 443-529-0660
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R189956
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11025540
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License Number State | FL
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