Individual provider · Type 1 NPI
Nicole Ray Tychostup, RN
Psychiatric/Mental Health Nurse Practitioner · Waterford, NY
NPI number
1013776137
Active
Practice location
107 4th St
Waterford, NY 12188-2025
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 409247 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
About NPI 1013776137
Nicole Ray Tychostup, RN's National Provider Identifier is 1013776137, issued on Mar 19, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Waterford, NY. The record was last updated on Sep 22, 2026.