Individual provider Active NPI

Nicole Abraham, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1427631969
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012087 Issued in FL
Practice address
2784 Freehold Ave SE
Palm Bay, FL 32909-8611
Phone
(321) 536-0495
NPI assigned
May 3, 2021
Last updated
May 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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 11012087 FL Primary

Addresses

Primary practice location

2784 Freehold Ave SE
Palm Bay, FL 32909-8611

Mailing address

2784 Freehold Ave SE
Palm Bay, FL 32909-8611
Phone (321) 536-0495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404002389 FL Practitioner - Nurse Practitioner 0244605228 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11012087FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Providers of America, LLC CurrentSince Sep 24, 2023 Accepting new patients
East Lake Chiropractic and Injury Center Inc PastSince Jan 10, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1427631969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 FREEHOLD AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098611",
            "telephone_number": "321-536-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2784 FREEHOLD AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098611",
            "telephone_number": "321-536-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "NICOLE",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.