Provider Demographics
NPI:1376250878
Name:GARCIA, NICHOLAS KLINE (BSN APRN PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:KLINE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:BSN APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 ROUTE 73 S STE 210
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4133
Mailing Address - Country:US
Mailing Address - Phone:856-399-1010
Mailing Address - Fax:
Practice Address - Street 1:750 ROUTE 73 S STE 210
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4133
Practice Address - Country:US
Practice Address - Phone:856-399-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01374500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health