Doctor Name: | MS. CATHY NICHOLAS |
NPI Number: | 1033484076 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | A0610012 |
Business Practice Address: | 385 Tremont Ave East Orange, NJ - 070181023 |
Business Phone Number: | 9733363811 |
Business Fax Number: | |
Mailing Address: | 114 Bedford St, EAST ORANGE |
State: | NJ |
Postal Code: | 070181830 |
Phone Number: | 9733363811 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2012 |
NPI Last Update Date: | 03/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | A0610012 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |