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NICOLE GRACE FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103-6951
(336) 718-3550
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
330439
NY
2084P0800X
Psychiatry Physician
Primary
2025-03539
NC

Other

Enumeration date
05/13/2019
Last updated
01/15/2026
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