Provider Demographics
NPI:1609560051
Name:JOSEPH, NICOLA N (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:N
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 BREMO RD STE 403
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1924
Mailing Address - Country:US
Mailing Address - Phone:804-513-6469
Mailing Address - Fax:
Practice Address - Street 1:5855 BREMO RD STE 403
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1924
Practice Address - Country:US
Practice Address - Phone:804-513-6469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily