Individual
MS. NICHOLE C PAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST/CSFA
Contact information
Practice address
1604 VISA DR., STE. 1, NORMAL, IL 61761
(309) 846-4716
(309) 454-7348
Mailing address
1604 VISA DR., STE. 1, NORMAL, IL 61761
(309) 846-4716
(309) 454-7348
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238.000.120
IL
246ZS0410X
Surgical Technologist
238.000120
IL
Other
Enumeration date
10/28/2008
Last updated
03/03/2022
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