Individual
DR. JANE ALICE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
255 4TH ST NE, PRIMGHAR, IA 51245-1004
(712) 630-1243
Mailing address
255 4TH ST NE, PRIMGHAR, IA 51245-1004
(712) 630-1243
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001103
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087059535038
—
VA
Enumeration date
03/01/2009
Last updated
03/01/2009
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