Individual
NICHOLAS JOHN NEWBOLD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
22395 EDGEWATER DR, PORT CHARLOTTE, FL 33980-2012
(941) 766-7222
(941) 766-0970
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP3395152
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN3395152
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122549300
—
FL
Enumeration date
02/16/2018
Last updated
02/23/2026
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