Provider Demographics
NPI:1104196864
Name:NICHOLSON, VELMA V (REGISTERED NURSE BSN)
Entity Type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:V
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:REGISTERED NURSE BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 MATTHEWS AVE PH
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8607
Mailing Address - Country:US
Mailing Address - Phone:718-710-1737
Mailing Address - Fax:
Practice Address - Street 1:2741 MATTHEWS AVE PH
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8607
Practice Address - Country:US
Practice Address - Phone:718-710-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526905-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse