Individual
LAURIE A NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APN-C
Contact information
Practice address
2848 S DELSEA DR STE 2C, VINELAND, NJ 08360-7042
(856) 794-9090
Mailing address
2848 S DELSEA DR STE 2C, VINELAND, NJ 08360-7042
(856) 794-9090
(856) 794-3058
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
26NJ00189000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NJ
Enumeration date
05/29/2009
Last updated
02/17/2020
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