MEDICARE: NICHOLAS COSTANTINI

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	331680	NC

General Provider Information

NPI Number	:	1982530861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS COSTANTINI

Provider Business Mailing Address
First Line	:	2634 BLACKWOLF RUN LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-5428
Country	:	US
Telephone Number	:	714-323-2906
Fax Number	:

Provider Business Practice Location Address
First Line	:	2634 BLACKWOLF RUN LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-5428
Country	:	US
Telephone Number	:	714-323-2906
Fax Number	:

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

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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Directions to “ NICHOLAS COSTANTINI ” Practice Location

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