Provider Demographics
NPI:1619362837
Name:NICOLI, EMILY (CRNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:NICOLI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 NOTTINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8429
Mailing Address - Country:US
Mailing Address - Phone:443-529-0660
Mailing Address - Fax:
Practice Address - Street 1:99 NOTTINGHAM PL
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8429
Practice Address - Country:US
Practice Address - Phone:443-529-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189956363LA2200X, 363LP2300X
FLAPRN11025540363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health