Individual
ELIZABETH LEE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3636 N BELT W, BELLEVILLE, IL 62226-5947
(618) 233-5050
Mailing address
1428 CLIFTON WAY CT, O FALLON, IL 62269-7394
(618) 977-3784
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.009368
IL
Other
Enumeration date
02/09/2012
Last updated
12/18/2016
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