Individual
MARY LEE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-7033
Mailing address
146 VIDAL BLVD, DECATUR, GA 30030-2345
(404) 373-4797
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN050631 NP
GA
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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