Individual
TARA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
910 N EISENHOWER AVE, MASON CITY, IA 50401-1525
(641) 428-5911
(641) 428-5927
Mailing address
600 1ST ST NW STE 101, MASON CITY, IA 50401-2932
(641) 428-3041
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
W158701
IA
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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