Individual
AMANDA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
3263 EATON RD, GREEN BAY, WI 54311-6830
(920) 433-6700
(920) 433-6719
Mailing address
2740 W MASON ST, GREEN BAY, WI 54303-4966
(920) 498-5436
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4571-33
WI
363LF0000X
Family Nurse Practitioner
Primary
4571-33
WI
Other
Enumeration date
10/05/2011
Last updated
06/20/2023
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