Individual
MS. PATRICIA ANN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
224B CORNWALL ST NW, LOUDOUN FREE CLINIC, LEESBURG, VA 20176-2701
(703) 779-5416
(703) 779-5407
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001790
VA
363A00000X
Physician Assistant
C01483
MD
Other
Enumeration date
12/05/2006
Last updated
12/27/2011
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