| Doctor Name: | MS. TANYA A NICHOLS |
| NPI Number: | 1013234277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN CDE |
| License Number: | RN9206105 |
| Business Practice Address: | 5205 Greenwood Ave 110 West Palm Beach, FL - 334072400 |
| Business Phone Number: | 5618038880 |
| Business Fax Number: | 5618038899 |
| Mailing Address: | 4858 S Classical Blvd, DELRAY BEACH |
| State: | FL |
| Postal Code: | 334451235 |
| Phone Number: | 5616378749 |
| Fax Number: | 5618038899 |
| NPI Enumeration Date: | 04/28/2010 |
| NPI Last Update Date: | 04/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | RN9206105 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |