Individual
DR. SHANTRICE BERNICE NICHOLS-BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
350 W WOODROW WILSON AVE STE 1010, JACKSON, MS 39213-7681
(769) 366-4719
(769) 366-4717
Mailing address
350 W WOODROW WILSON AVE STE 1010, JACKSON, MS 39213-7681
(769) 366-4719
(769) 366-4717
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201508267NP-PP
OR
363LF0000X
Family Nurse Practitioner
Primary
901369
MS
363LF0000X
Family Nurse Practitioner
GAA-NP000049
GA
Other
Enumeration date
11/04/2015
Last updated
05/15/2026
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