Individual
MS. JUDY LYNN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NEMT
Contact information
Practice address
2311 W MADDOX RD, JACKSONVILLE, AR 72076-8771
(925) 695-6038
Mailing address
2311 W MADDOX RD, JACKSONVILLE, AR 72076-8771
(925) 695-6038
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
29160381
TX
172A00000X
Driver
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
965208
—
AR
Enumeration date
11/07/2019
Last updated
11/07/2019
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