| NPI | 1780647586 |
|---|---|
| Former Name | DAWNELLE MARIE NICHOLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209005943) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005943) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G-113375) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 7345-33) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2022-04-05 |