Individual
COURTNEY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 W SOUTH 3RD ST, SHELBYVILLE, IL 62565-9595
(217) 774-2113
Mailing address
1810 W SOUTH 3RD ST, SHELBYVILLE, IL 62565-9595
(217) 774-2113
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043113407
IL
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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