Individual
DR. HEATHER RUTHANN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
514 S 9TH ST, VINCENNES, IN 47591-2709
(812) 882-8510
(812) 885-8511
Mailing address
514 S 9TH ST, VINCENNES, IN 47591-2709
(812) 882-8510
(812) 885-8511
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01068320A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000681708
ANTHEM
IN
05
—
201003480
—
IN
01
—
26-3086555
TAX I.D.
IN
01
—
262813100
TAX ID
IN
Enumeration date
07/19/2007
Last updated
01/20/2025
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