Provider Demographics
NPI:1497278527
Name:VESPUCCI, NICHOLAS (L AC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:VESPUCCI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7371 KINDLER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2203
Mailing Address - Country:US
Mailing Address - Phone:443-812-4824
Mailing Address - Fax:
Practice Address - Street 1:53 OLD SOLOMONS ISLAND RD STE C
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3872
Practice Address - Country:US
Practice Address - Phone:410-263-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02401171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist