Individual
MRS. DEETTE KAY NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
805 QUAIL RIDGE COURT, ELIZABETHTON, TN 37643
(423) 543-1681
(423) 543-1681
Mailing address
805 QUAIL RIDGE COURT, ELIZABETHTON, TN 37643
(423) 543-1681
(423) 543-1681
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
APN0000012088
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128CV
NORTH CAROLINA BC BS PROV
—
01
—
3116374
TENNESSEE BC BS PROVIDER
—
Enumeration date
04/23/2007
Last updated
07/08/2007
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