Individual
MRS. JUDY R MACNICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1070 N. STONE STREET, SUITE A, DELAND, FL 32720
(386) 943-7100
(386) 738-8909
Mailing address
1070 N STONE ST, SUITE A, DELAND, FL 32720-0919
(386) 943-7100
(386) 943-8909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA3264
FL
363AM0700X
Medical Physician Assistant
Primary
PA3264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290967700
—
FL
Enumeration date
08/12/2005
Last updated
02/19/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us