Individual
LISA NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
18101 PRINCE PHILIP DR, OLNEY, MD 20832-1514
(301) 774-8882
Mailing address
7986 LAKECREST DR, GREENBELT, MD 20770-3306
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R239037
MD
363LF0000X
Family Nurse Practitioner
Primary
R239037
MD
Other
Enumeration date
04/23/2025
Last updated
08/08/2025
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