MEDICARE: NICOLLE A ABELOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN11004137	FL
2	363LF0000X	Family Nurse Practitioner	95032302	CA
3	363LF0000X	Family Nurse Practitioner	LG-0012953	DE
4	363LF0000X	Family Nurse Practitioner	GAA-NP002744	GA
5	363LF0000X	Family Nurse Practitioner	4704419626	MI
6	363LF0000X	Family Nurse Practitioner	12081	MN
7	363LF0000X	Family Nurse Practitioner	2024036920	MO
8	363LF0000X	Family Nurse Practitioner	906963	MS
9	363LF0000X	Family Nurse Practitioner	115636	NE
10	363LF0000X	Family Nurse Practitioner	112472-23	NH
11	363LF0000X	Family Nurse Practitioner	882352	NV
12	363LF0000X	Family Nurse Practitioner	10031127	OR
13	363LF0000X	Family Nurse Practitioner	SP031773	PA
14	363LF0000X	Family Nurse Practitioner	1177677	TX
15	363LF0000X	Family Nurse Practitioner	APRN1104137	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235780537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLLE A ABELOW

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-6775
Fax Number	:

Provider Business Practice Location Address
First Line	:	11178 STATE ROAD 54 STE A
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-2266
Country	:	US
Telephone Number	:	727-372-4200
Fax Number	:	727-333-6371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	01/31/2025

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Directions to “ NICOLLE A ABELOW ” Practice Location

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