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Individual

SHAKIA AMANI NICHOLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7501 SURRATTS RD STE 308, CLINTON, MD 20735-3377
(301) 877-7200
Mailing address
22 BAGLEY ST, PORTSMOUTH, VA 23704-6105
(757) 633-8873

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024182878
VA
363L00000X
Nurse Practitioner
Primary
NP20000532
DC

Other

Enumeration date
12/06/2021
Last updated
06/17/2024
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