# JENNA NICHOLS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1558042820
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 28248429A | IN | — |
| 363L00000X | Nurse Practitioner | 71014206A | IN | Yes |

## Other

- **Enumeration date:** 07/28/2023
- **Last updated:** 11/02/2023