Individual
LORI NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP151108
ME
Other
Enumeration date
08/26/2015
Last updated
12/13/2017
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