Individual
CASEY A NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
700 SUNSET DR STE F, LA GRANDE, OR 97850-1260
(541) 663-3030
(541) 975-5201
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-1967
(541) 963-1837
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN 9178702
FL
363LF0000X
Family Nurse Practitioner
Primary
201706907NP-PP
OR
Other
Enumeration date
05/03/2007
Last updated
09/10/2018
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