Individual
NICOLE GRACE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
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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