Provider Demographics
NPI:1508610148
Name:TROGDON, NICKOLAS CHARLES (FNP)
Entity type:Individual
Prefix:
First Name:NICKOLAS
Middle Name:CHARLES
Last Name:TROGDON
Suffix:
Gender:M
Credentials:FNP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1448 10TH AVENUE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:304-691-6381
Mailing Address - Fax:304-691-8591
Practice Address - Street 1:1249 15TH STREET
Practice Address - Street 2:SUITE 3000
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3662
Practice Address - Country:US
Practice Address - Phone:304-691-1000
Practice Address - Fax:304-691-1693
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV108418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily