Individual
MR. PERRY DUANE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 424-6136
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 424-6136
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN076397-AP03519
LA
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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