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Individual

MS. IRENE S. NICHOLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6325 W JOHNS XING, DULUTH, GA 30097-5746
(404) 778-8311
(404) 495-1585
Mailing address
1540 HERITAGE TRL, ROSWELL, GA 30075-4897
(404) 433-4657
(770) 650-2713

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN096684
GA

Other

Enumeration date
10/04/2006
Last updated
08/18/2015
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