Individual
COURTNEY R NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1611 S BALTIMORE ST STE A, KIRKSVILLE, MO 63501-4519
(660) 665-7575
(660) 665-7576
Mailing address
PO BOX 1239, HANNIBAL, MO 63401-1239
(660) 665-7575
(660) 665-7576
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2007025283
MO
363LF0000X
Family Nurse Practitioner
Primary
2017042162
MO
Other
Enumeration date
12/15/2017
Last updated
03/17/2018
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