| Doctor Name: | MRS. DEANNA ARLENE NICHOLS |
| NPI Number: | 1750464517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 3004997 |
| Business Practice Address: | 200 N Crawford St Ste 3 Tompkinsville, KY - 421671617 |
| Business Phone Number: | 2704075052 |
| Business Fax Number: | 2704075053 |
| Mailing Address: | Po Box 669, 200 N Crawford Street Suite 3 TOMPKINSVILLE |
| State: | KY |
| Postal Code: | 421670669 |
| Phone Number: | 2704075052 |
| Fax Number: | 2704075053 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 06/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3004997 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |