Individual
MRS. AMANDA JEAN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1958 CO RD 1035, ASHLAND, OH 44805
(419) 545-0402
Mailing address
1958 COUNTY ROAD 1035, ASHLAND, OH 44805-9236
(419) 545-0402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN. 122108-M-IV
OH
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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