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General NPI Number Information
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NPI Number | 1912670274
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Entity Type | Individual
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Provider Name | NICOLETTE HUNEYCUTT MCCRARY APRN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2021
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 22738 MAPLE RD STE 214
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3348
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Country | US
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Telephone | 240-237-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 22738 MAPLE RD STE 214
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3348
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Country | US
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Telephone | 704-472-8303
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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 | 11015481
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95017891
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC004644
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | AC004644
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License Number State | MD
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