Individual
BRANDY NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 N MAIN ST, CARLSBAD, NM 88220-5896
(575) 885-0956
(575) 887-9579
Mailing address
914 N CANAL ST, CARLSBAD, NM 88220-5110
(575) 885-4836
(575) 887-9579
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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