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Individual

ASHLEY LYNN NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
507 JACOB ST, TIMPSON, TX 75975
(936) 254-3338
(936) 254-3339
Mailing address
PO BOX 847522, DALLAS, TX 75284-7522
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APP133508
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
371981702
TX
01
647220
MEDICARE
TX
01
P02028472
MEDICARE RAIL ROAD
TX
Enumeration date
03/06/2017
Last updated
06/18/2018
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