MEDICARE: MS. CATHERINE DELITA NICHOLSON PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	883883	NV

General Provider Information

NPI Number	:	1679393912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE DELITA NICHOLSON PMHNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 335454
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89033-5454
Country	:	US
Telephone Number	:	504-919-0939
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 335454
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89033-5454
Country	:	US
Telephone Number	:	504-919-0939
Fax Number	:

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

Provider Enumeration Date	:	10/11/2024
Last Update Date	:	02/08/2025

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