Individual
EMMA NICHOLSON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6202
Mailing address
7002 HANDRICH CT APT D, FORT STEWART, GA 31315-5897
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329131
TX
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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