Individual
MS. BETTY JANE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, RN
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 395-9304
(405) 395-9305
Mailing address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 395-9304
(405) 395-9305
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
102230
OK
164W00000X
Licensed Practical Nurse
L 0058799
OK
Other
Enumeration date
08/31/2010
Last updated
04/19/2012
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