Individual
PAULINE T. NICHOL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 COMMONWEALTH DR, GREENVILLE, SC 29615-4812
(864) 675-4000
Mailing address
104 WATER MILL RD, GREER, SC 29650-3622
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A417
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00234816
RAILROAD MEDICARE
SC
Enumeration date
06/07/2006
Last updated
07/08/2007
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