| NPI | 1740904358 |
|---|---|
| Former Name | JESSICA ANN NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71016132A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28291709A) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F349214-01) | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2025-01-29 |