Individual
MRS. STEPHANIE ANN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S 4TH ST, BARDSTOWN, KY 40004-1008
(592) 338-5443
Mailing address
202 S 4TH ST, BARDSTOWN, KY 40004-1008
(502) 380-7765
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1123138
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
1123138
KY
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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