Provider Demographics
NPI:1225906928
Name:NICHOLS, EMILY CAROLYN (FNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CAROLYN
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11624 TRUAN LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9040
Mailing Address - Country:US
Mailing Address - Phone:203-605-0229
Mailing Address - Fax:
Practice Address - Street 1:11624 TRUAN LN
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-9040
Practice Address - Country:US
Practice Address - Phone:203-605-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-25
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty