Individual
BRANDI NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 636-5248
(573) 636-9390
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2010017190
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578656674
—
MO
Enumeration date
10/02/2006
Last updated
08/14/2023
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