Individual
MEMORIE MORGAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1279 HIGHWAY 54 W, SUITE 210, FAYETTEVILLE, GA 30214-4550
(770) 719-5710
Mailing address
1279 HIGHWAY 54 W, SUITE 210, FAYETTEVILLE, GA 30214-4550
(770) 719-5710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005320
GA
Other
Enumeration date
03/19/2008
Last updated
10/28/2016
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