Individual
NICOLE SHANTEL JOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
1221 G ST NE, WASHINGTON, DC 20002-4423
(703) 489-2585
Mailing address
PO BOX 48502, WASHINGTON, DC 20002-0502
(703) 489-2585
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
0129-00065
VA
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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