Individual
DR. NICOLE DORA LICATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, RN, FNP-BC
Contact information
Practice address
7200 CREEDMOOR RD STE 208, RALEIGH, NC 27613-1711
(919) 701-5157
Mailing address
20 MAYO ST APT A2, RALEIGH, NC 27603-1532
(908) 902-9580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5013426
NC
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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