Individual
SAMANTHA SUE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3138
Mailing address
4000 WILSON BLVD APT 505, ARLINGTON, VA 22203-4404
(404) 931-7374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
925980
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
0024183333
VA
Other
Enumeration date
12/21/2021
Last updated
05/09/2022
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