Individual
COURTNEY N NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD STE 2201, JACKSONVILLE, FL 32258-7418
(904) 880-9696
(904) 390-7452
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9114339
FL
363AM0700X
Medical Physician Assistant
PA9114339
FL
Other
Enumeration date
04/23/2021
Last updated
04/14/2023
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