MEDICARE: DR. NICHOLAS DAMICO DNP AGNP C PLLC

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	AG09230015	NC
2	363LA2200X	Adult Health Nurse Practitioner	5019138	NC

General Provider Information

NPI Number	:	1538949896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS DAMICO DNP AGNP C PLLC

Provider Business Mailing Address
First Line	:	125 EDINBURGH SOUTH DR STE 105
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-6484
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 EDINBURGH SOUTH DR STE 105
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-6484
Country	:	US
Telephone Number	:	919-800-7274
Fax Number	:

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

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	02/12/2026

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