Individual
JACQUELYN D NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500
Mailing address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006030
IL
Other
Enumeration date
11/16/2016
Last updated
11/13/2019
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