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Individual

MRS. DENISE E NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1465 COUNTY ROAD 365, CRANE HILL, AL 35053-4038
(256) 590-3613
(256) 747-2262
Mailing address
1465 COUNTY ROAD 365, CRANE HILL, AL 35053-4038
(256) 590-3613
(256) 747-2262

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-071048
AL
367500000X
Certified Registered Nurse Anesthetist
ARNP9204451
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009931961
AL
05
306034900
FL
01
59200186
BCBS
AL
01
59200187
BCBS
AL
01
G3398
BCBS
FL
01
P00197074
PALMETTO GBA-RR MEDICARE
Enumeration date
05/17/2006
Last updated
11/23/2015
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