Individual
JENNIFER NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
410 4TH ST STE J, ALVA, OK 73717-2363
(580) 430-3333
(580) 430-3375
Mailing address
PO BOX 727, ALVA, OK 73717-0727
(580) 430-3333
(580) 430-3375
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
90378
OK
363LF0000X
Family Nurse Practitioner
Primary
90378
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200589510A
—
OK
Enumeration date
05/01/2015
Last updated
07/18/2025
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