Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Aileen Ortlieb

Individual provider Physician Assistant · NPI 1801663539

Nicole Aileen Ortlieb is a Physician Assistant in Fernandina Beach, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2023

Practice location Address checks out

96112 Lanceford Ln
Fernandina Beach, FL 32034-6197
Phone: (301) 520-0658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1200729 (FL)

Record details

NPI number1801663539
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 4, 2023
Last updated in NPPESDecember 4, 2023
Certification dateDecember 4, 2023
Mailing address96112 Lanceford Ln, Fernandina Beach, FL 32034-6197

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