Individual
KATIE NICOSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
470 N VILLA RD, NEWBERG, OR 97132-1858
(503) 406-1009
(503) 200-2975
Mailing address
470 N VILLA RD, NEWBERG, OR 97132-1858
(503) 406-1009
(503) 200-2975
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200750105NP
OR
Other
Enumeration date
12/27/2007
Last updated
03/06/2020
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