Individual
MS. DEBRA J NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
193 MAIN ST, SUITE 9, NORWAY, ME 04268-5645
(207) 743-8766
(207) 743-1579
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP81672
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252320099
—
ME
Enumeration date
01/10/2007
Last updated
11/01/2012
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