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Individual

DIANNE NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871
(301) 373-7900
(301) 373-6900
Mailing address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C00D1975
MD

Other

Enumeration date
07/18/2006
Last updated
07/08/2007
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