Individual provider Active NPI

Nickesha Nelson

  • Family Nurse Practitioner
  • Palm Beach Gardens, FL
National Provider Identifier
1043660806
Registry record updated Jun 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9314126 Issued in FL
Practice address
2480 Pga Blvd
Palm Beach Gardens, FL 33410-3507
Phone
(561) 622-8700
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9314126 FL Primary

Addresses

Primary practice location

2480 Pga Blvd
Palm Beach Gardens, FL 33410-3507

Mailing address

2480 Pga Blvd
Palm Beach Gardens, FL 33410-3507
Phone (561) 622-8700

Other identifiers 1

IdentifierTypeStateIssuer
9310146OtherARNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9314126FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1043660806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103507",
            "telephone_number": "561-622-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103507",
            "telephone_number": "561-622-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "NICKESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9314126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "9310146",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.