MEDICARE: MRS. NICOLE HOWARD FNP

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	163W00000X	Registered Nurse	L1-0039291	DE
2	363L00000X	Nurse Practitioner	LG-0001175	DE
3	363LF0000X	Family Nurse Practitioner	LG-0001175	DE

General Provider Information

NPI Number	:	1801351564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE HOWARD FNP

Provider Business Mailing Address
First Line	:	419 WESTON DR
Second Line	:
City	:	MIDDLETOWN
State	:	DE
Zip	:	19709-1715
Country	:	US
Telephone Number	:	302-233-1758
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S MAIN ST STE 205
Second Line	:
City	:	SMYRNA
State	:	DE
Zip	:	19977-1479
Country	:	US
Telephone Number	:	302-653-6022
Fax Number	:	302-389-1094

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

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	10/07/2024

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