| NPI | 1336678127 |
|---|---|
| Former Name | CONSTANCE MARIE NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP108817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 237290) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2020-06-03 |