Individual
MS. NICKLITA TAMICA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2052 TILLOTSON AVE, BRONX, NY 10475-1560
(718) 671-2100
Mailing address
11841 199TH ST, SAINT ALBANS, NY 11412-3429
(929) 257-7039
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404548
NY
Other
Enumeration date
08/20/2013
Last updated
11/09/2022
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