Individual
MS. DIANE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 JOE E BROWN AVE, HOLGATE, OH 43527-9802
(419) 264-5231
Mailing address
801 JOE E BROWN AVE, HOLGATE, OH 43527-9802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN057904
OH
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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