Individual
MARY SUE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4098 EDGMONT AVE, BROOKHAVEN, PA 19015-2211
(866) 825-3227
(484) 450-2617
Mailing address
161 WASHINGTON ST, EIGHT TOWER BRIDGE STE 1400, CONSHOHOCKEN, PA 19428-2083
(866) 825-3227
(484) 450-2617
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP007470
PA
Other
Enumeration date
09/29/2008
Last updated
09/29/2008
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