Active NPI
Nicole Dora Licato, DNP, RN, FNP-BC
- Family Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1710598644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5013426
- Practice address
- 7200 Creedmoor Rd Ste 208
Raleigh, NC 27613-1711 - Phone
- (919) 701-5157
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5013426 | NC | Primary |
Addresses
Primary practice location
7200 Creedmoor Rd Ste 208
Raleigh, NC 27613-1711
Mailing address
20 Mayo St Apt A2
Raleigh, NC 27603-1532
Phone (908) 902-9580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
Interoperability endpoints
- nlicato276273@direct.medicine.duke.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1710598644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MAYO ST APT A2",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276031532",
"telephone_number": "908-902-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 CREEDMOOR RD STE 208",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276131711",
"telephone_number": "919-701-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICATO",
"first_name": "NICOLE",
"middle_name": "DORA",
"name_prefix": "Dr.",
"credential": "DNP, RN, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5013426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.