Individual
HAROLD THOMAS NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4212 NE KENNESAW RDG, LEES SUMMIT, MO 64064-1379
(816) 616-6376
Mailing address
4212 NE KENNESAW RDG, LEES SUMMIT, MO 64064-1379
(816) 616-6376
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
108988
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001673730
STATE OF MISSOURI
MO
Enumeration date
03/23/2020
Last updated
03/23/2020
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