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General NPI Number Information
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NPI Number | 1811560972
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Entity Type | Individual
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Provider Name | NICOLE HERBERGER NP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 106 ELDEN ST UNIT 26
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City | HERNDON
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State | VA
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Zip | 20170-4872
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Country | US
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Telephone | 256-302-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 THEMIS ST SE
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City | LEESBURG
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State | VA
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Zip | 20175-5098
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Country | US
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Telephone | 814-244-8861
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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 | 0024181465
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License Number State | VA
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