Nancy Carolina Nicoloso, NP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AP13782 Issued in TX

Practice address

6302 Lake Worth Blvd Ste A3963
Fort Worth, TX 76135-3607

Phone

(817) 237-8273

NPI assigned

Nov 15, 2018

Last updated

Nov 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1952870354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 PRAIRIE TIMBER RD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287687",
            "telephone_number": "817-504-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 LAKE WORTH BLVD STE A3963",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761353607",
            "telephone_number": "817-237-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOSO",
        "first_name": "NANCY",
        "middle_name": "CAROLINA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP13782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Ragnauth Nickerson, MA, LPC
• Jena Suzanne Nickerson, BCBA LBA-TX
• Toyree Nickerson
• Vicki Nicklas, PT
• Alford Frederick Nicol
• Derek Nieber, M.D.
• Brigette Ann Nielsen
• Curtis Nielsen, CRNA, DNP
• Stephanie Nielsen, MD
• Karen Lanette Nielson, M.D.

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.