Individual
TERESA NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 KIRKLAND RD, COVINGTON, GA 30016-3317
(678) 209-2770
Mailing address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 374-5199
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN236153
GA
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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