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Individual

CRAIG JASON NICHOLSON-UHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
4500 10TH ST, MARRERO, LA 70072-3122
(504) 349-6352
(504) 349-6356
Mailing address
4500 10TH ST, MARRERO, LA 70072-3122
(504) 349-6352
(504) 349-6356

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP05817
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1885215
LA
01
AP05817
LICENSE
LA
Enumeration date
06/25/2009
Last updated
01/17/2014
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