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Individual
NICOLE ABDULLAH
Active
Individual
NICOLE ABDULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-13108
NC
363A00000X
Physician Assistant
11030
GA
363A00000X
Physician Assistant
1547278
NY
363A00000X
Physician Assistant
4860
SC
363A00000X
Physician Assistant
5845
AZ
363A00000X
Physician Assistant
C0008248
MD
363A00000X
Physician Assistant
PA.0007287
CO
363A00000X
Physician Assistant
PA15814
TX
363A00000X
Physician Assistant
Primary
PA60514722
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285032268
—
WA
01
—
339454
WVH LNI
WA
01
—
P01461864
RR MEDICARE WVH
WA
Enumeration date
12/08/2014
Last updated
05/12/2023
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