Individual
CHEYENNE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
590 LOUIS J AVE, TALENT, OR 97540-9773
(541) 282-4604
Mailing address
500 MONROE ST, MEDFORD, OR 97501-3522
(541) 608-6868
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7548724
OR
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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