DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICOLE PAULINE DETRICK

Active Sole Proprietor

NICOLE PAULINE DETRICK is a Physician Assistant healthcare provider located in JACKSONVILLE, Florida. NPI 1760172761 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · JACKSONVILLE, FL

Registration Details

NPI Number
1760172761
Provider Type
Individual
Gender
Female
NPI Issued
May 11, 2023 (3.2517716984563 yrs)
Last Updated
Dec 18, 2024
Licenses
MA064732 (PA)
PA9119031 (FL)
Sole Proprietor
Yes

Practice Information

Address
6269 BEACH BLVD
JACKSONVILLE, FL, 322162768
Browse FL providers · Browse ZIP 32216
Phone
9047277955
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in JACKSONVILLE, FL

Name Credential NPI
MR. JASON KOTULA P.A. 1548263882
DANIEL A BECK PA-C 1780688465
JOHN MICHAEL TIERNEY PA 1124023445
KAREN ELAINE MAYES PA 1437154887
EDWIN HAUSER PA 1760487185
PETER J RIGGS PA 1255336574
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.