Individual
JENNIFER RUTH NICHELSON
Active
Individual
JENNIFER RUTH NICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
209.007151
IL
363LF0000X
Family Nurse Practitioner
Primary
209007151
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01775273
RAILROAD
IL
Enumeration date
08/01/2008
Last updated
05/20/2019
Update your record
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