Individual
BOBBY RAY NICHOLS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2204 PAVILION DR STE 200, KINGSPORT, TN 37660-4652
(423) 224-3900
(423) 224-3901
Mailing address
2204 PAVILION DR STE 200, KINGSPORT, TN 37660-4652
(423) 224-3900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26999
TN
Other
Enumeration date
02/11/2020
Last updated
11/26/2024
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