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Individual
LIEN T NICHOLS
Active
Individual
LIEN T NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
012832-1
NY
363A00000X
Physician Assistant
Primary
PA06749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114141806
—
TX
Enumeration date
10/09/2008
Last updated
03/10/2023
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