Individual
AMANDA EVANS NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
738 S LONGMORE, MESA, AZ 85202-1908
(480) 472-4360
(480) 472-4350
Mailing address
745 N 25TH ST, MESA, AZ 85213-6898
(840) 241-1842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
24725391
AZ
Other
Enumeration date
02/02/2024
Last updated
02/05/2024
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