Individual
LANI JEANNE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
460 QUINCY AVE, QUINCY, MA 02169-8130
(617) 847-1950
(617) 774-1490
Mailing address
500 VICTORY RD, QUINCY, MA 02171-3139
(617) 847-1950
(617) 774-1490
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
59991
MA
2084P0804X
Child & Adolescent Psychiatry Physician
59991
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J12395
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
08/05/2006
Last updated
09/11/2025
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