Individual
ANNA ALEXIS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 PRESIDENTIAL PLZ, SYRACUSE, NY 13202-2240
(315) 464-5210
Mailing address
90 PRESIDENTIAL PLZ, SYRACUSE, NY 13202-2240
(315) 464-5210
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
10/16/2025
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