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Individual

WENDY S NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
35 MILES ST., MILES MEDICAL GROUP, DAMARISCOTTA, ME 04543
(207) 563-4511
(207) 563-4103
Mailing address
35 MILES ST., MILES MED. GROUP - ANESTHESIA, DAMARISCOTTA, ME 04543
(207) 563-4511
(207) 563-4103

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
44707
ME
367500000X
Certified Registered Nurse Anesthetist
R044707
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
321630099
ME
Enumeration date
04/06/2007
Last updated
10/02/2008
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