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General NPI Number Information
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NPI Number | 1730858721
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Entity Type | Individual
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Provider Name | NICHOLE MARIE MCLEOD PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 5775 BROADWAY ST
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City | LANCASTER
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State | NY
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Zip | 14086-2456
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Country | US
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Telephone | 716-544-8848
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Fax | 888-612-0831
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Provider Business Mailing Address
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Address Line | 81 DARTWOOD DR
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-3121
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Country | US
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Telephone | 716-578-5788
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405506
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 732698
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License Number State | NY
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