Individual
MRS. BRANDIE NICOLE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-3628
(423) 230-8502
Mailing address
105 W STONE DR STE 6A, KINGSPORT, TN 37660-3256
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
178442
TN
363LF0000X
Family Nurse Practitioner
Primary
22754
TN
Other
Enumeration date
06/20/2017
Last updated
12/04/2018
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