Individual
MRS. MINDI NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 320-7691
(570) 320-7898
Mailing address
1201 GRAMPIAN BLVD, SUITE 1K, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP014100
PA
Other
Enumeration date
07/31/2014
Last updated
09/09/2014
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