MEDICARE: NICOLE POCETTI

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	363LA2100X	Acute Care Nurse Practitioner	26NJ01193700	NJ
2	363LA2100X	Acute Care Nurse Practitioner	30743	SC

General Provider Information

NPI Number	:	1922776228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE POCETTI

Provider Business Mailing Address
First Line	:	603 LOMBARD ST APT A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9228 MEDICAL PLAZA DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29406-9125
Country	:	US
Telephone Number	:	843-574-5693
Fax Number	:	843-764-4512

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

Provider Enumeration Date	:	09/01/2021
Last Update Date	:	02/16/2026

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Directions to “ NICOLE POCETTI ” Practice Location

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