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Individual

NICOLE USSIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, ATC

Contact information

Practice address
600 HOSPITAL DR, MONROE, NC 28112-6000
(980) 993-3100
Mailing address
6705 WALNUT BRANCH LN APT 10310, CHARLOTTE, NC 28277-8933

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9116817
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
FL
Enumeration date
01/03/2017
Last updated
04/28/2023
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