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General NPI Number Information
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NPI Number | 1619785102
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Entity Type | Individual
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Provider Name | NICOLE MORALES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 110 W 20TH ST
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City | NORFOLK
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State | VA
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Zip | 23517-2221
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Country | US
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Telephone | 757-996-0186
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Fax |
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Provider Business Mailing Address
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Address Line | 1486 HOLLY POINT RD
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City | NORFOLK
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State | VA
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Zip | 23509-1213
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Country | US
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Telephone | 773-747-0682
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024193115
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License Number State | VA
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