Provider Demographics
NPI:1679393912
Name:NICHOLSON, CATHERINE DELITA (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:DELITA
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335454
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89033-5454
Mailing Address - Country:US
Mailing Address - Phone:504-919-0939
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 335454
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89033-5454
Practice Address - Country:US
Practice Address - Phone:504-919-0939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV883883363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty