Doctor Name: | MS. JANNA SUE NICHOLS |
NPI Number: | 1780918490 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MS, FNP-C |
License Number: | 531115 |
Business Practice Address: | 12325 Aquaplex Buda, TX - 786105008 |
Business Phone Number: | 5124313088 |
Business Fax Number: | |
Mailing Address: | 12325 Aquaplex, BUDA |
State: | TX |
Postal Code: | 786105008 |
Phone Number: | 5124313088 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2009 |
NPI Last Update Date: | 12/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 531115 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |