Individual
JACQUELINE M NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
444 EXECUTIVE CENTER BLVD STE 148, EL PASO, TX 79902-1096
(915) 213-1289
Mailing address
444 EXECUTIVE CENTER BLVD STE 148, EL PASO, TX 79902-1096
(915) 213-1289
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
L0051764
OK
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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