Individual
JENNIFER NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
132 E BROADWAY BLVD, JEFFERSON CITY, TN 37760-2535
(865) 471-0548
Mailing address
132 E BROADWAY BLVD, JEFFERSON CITY, TN 37760-2535
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000028069
TN
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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