Individual
ANNE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1000 CHASTAIN RD NW, MAILSTOP 5200, KENNESAW, GA 30144-5588
(770) 423-6642
Mailing address
1085 YORK TRACE, MARIETTA, GA 30064
(770) 423-6642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN162196NP
GA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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