Individual
TAMARA JO NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4333 BELL RD, UNIT 1610, NEWBURGH, IN 47630-8177
(812) 202-0659
(812) 490-6259
Mailing address
4333 BELL RD, UNIT 1610, NEWBURGH, IN 47630-8177
(812) 202-0659
(812) 490-6259
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
28077920A
IN
163W00000X
Registered Nurse
Primary
28077920A
IN
Other
Enumeration date
06/08/2008
Last updated
06/08/2008
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