National Provider Identifier Database

NICOLE M THEODORE, REGISTERED NURSE – NPI #1588512776
Wound Care


Contact Information

NICOLE M THEODORE, REGISTERED NURSE
8221 PROVIDENT STREET
PHILADELPHIA, PA19150
Phone: 267-338-6382
Fax:
Website:
Specialty Taxonomy Code
* Wound Care 163WW0000X

* Indicates primary specialty

NPI Profile & details for NICOLE M THEODORE

NPI Number 1588512776
Credentials REGISTERED NURSE
Entity Individual
Enumeration date 03/21/2026
Last updated 03/21/2026 - About 3 months ago
Sole proprietor1 Yes
Identifiers
  • PA License #: RN615831
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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