Individual
JERMEY NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3084 WESTFORK DR, BATON ROUGE, LA 70816-2254
(225) 296-6083
Mailing address
3084 WESTFORK DR, BATON ROUGE, LA 70816-2254
(225) 362-1135
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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