Provider Demographics
NPI:1821466277
Name:NICKOLAOU, CHERYL ELAINE (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ELAINE
Last Name:NICKOLAOU
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6175 LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-2417
Mailing Address - Country:US
Mailing Address - Phone:810-743-1408
Mailing Address - Fax:810-743-1561
Practice Address - Street 1:6175 LAPEER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-2417
Practice Address - Country:US
Practice Address - Phone:810-743-1408
Practice Address - Fax:810-743-1561
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704217545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily