Individual
JESSICA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
503 4TH AVE, MONTGOMERY, WV 25136-2106
(304) 981-2361
Mailing address
516 HALL ST APT 4, CHARLESTON, WV 25302-1949
(304) 981-2361
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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