Individual
JILL E. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 CEDAR BEND DR, AUSTIN, TX 78758-5378
(512) 901-4016
(512) 901-3857
Mailing address
12221 N MOPAC EXPY, AUSTIN, TX 78758-2401
(512) 901-4016
(512) 901-3857
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J3361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105938801
—
TX
Enumeration date
04/13/2006
Last updated
02/01/2022
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