Individual
MRS. JACKI NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
5055 N ROCK CANYON RD, TUCSON, AZ 85750-6003
(520) 577-0293
Mailing address
5055 N ROCK CANYON RD, TUCSON, AZ 85750-6003
(520) 577-0293
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/06/2017
Last updated
10/06/2019
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