Provider Demographics
NPI:1093369894
Name:PASCARELLA, NICOLE MICHELE (DNP)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MICHELE
Last Name:PASCARELLA
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10250 NORMANDY BLVD UNIT 201
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-8066
Mailing Address - Country:US
Mailing Address - Phone:904-652-0870
Mailing Address - Fax:
Practice Address - Street 1:10250 NORMANDY BLVD UNIT 201
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-8066
Practice Address - Country:US
Practice Address - Phone:904-652-0870
Practice Address - Fax:904-652-2308
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9393595363LP2300X
FL11004038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care