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

Nicole Michelle Theodore, REGISTEREDNURSE

Individual provider Wound Care Registered Nurse · NPI 1588512776

Nicole Michelle Theodore, REGISTEREDNURSE is a Wound Care Registered Nurse in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2026

Practice location Address checks out

8221 Provident St
Philadelphia, PA 19150
Phone: (267) 338-6382
Show map & directions

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

Specialties & licences

Wound Care Registered Nurse (primary) Taxonomy 163WW0000X · Licence RN615831 (PA)

Record details

NPI number1588512776
Entity typeIndividual (Type 1)
GenderFemale
Credentials REGISTEREDNURSE
Sole proprietorYes
NPI enumeratedMarch 21, 2026
Last updated in NPPESMarch 21, 2026
Certification dateMarch 21, 2026

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