Individual
MRS. CAROL S NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
06748
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067484
—
SC
Enumeration date
04/22/2006
Last updated
11/16/2010
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