Individual
ROBERT DANIEL NICHOLAS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1781 STONEMAN DR, SUISUN CITY, CA 94585-3218
(678) 699-1559
Mailing address
1781 STONEMAN DR, SUISUN CITY, CA 94585-3218
(678) 699-1559
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN225769
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002292
CA
Other
Enumeration date
06/30/2021
Last updated
11/07/2024
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