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General NPI Number Information
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NPI Number | 1629882543
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Entity Type | Individual
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Provider Name | NICOLE MARIE KAPPAS FNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1847 S LAKE DR
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City | LEXINGTON
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State | SC
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Zip | 29073-7759
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Country | US
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Telephone | 803-356-8998
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Fax | 803-356-8999
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Provider Business Mailing Address
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Address Line | PO BOX 749306
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City | ATLANTA
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State | GA
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Zip | 30374-9306
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Country | US
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Telephone |
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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 | 12753805-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 30724
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License Number State | SC
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