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Individual
MRS. JANA RENEE NICHOLS
Active
Individual
MRS. JANA RENEE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR /L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR542
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130801721
—
AR
01
—
5T561
BCBS
AR
Enumeration date
08/14/2006
Last updated
04/15/2009
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