Individual
MRS. NICHOL RAULERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
620 10TH ST N, ST PETERSBURG, FL 33705-1407
(727) 824-7105
(727) 824-7125
Mailing address
620 10TH ST N STE 3A, ST PETERSBURG, FL 33705-1407
(727) 824-7105
(727) 824-7125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9103943
FL
363AM0700X
Medical Physician Assistant
Primary
PA9103943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010042400
—
FL
Enumeration date
10/17/2006
Last updated
04/13/2023
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