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Individual

JACQUELINE ECKERT NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5673 PEACHTREE DUNWOODY RD STE 870, ATLANTA, GA 30342-5029
(404) 255-2975
(404) 255-2276
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
SC
363AM0700X
Medical Physician Assistant
SC
363AS0400X
Surgical Physician Assistant
Primary
8003
GA
363AS0400X
Surgical Physician Assistant
SC

Other

Enumeration date
02/21/2011
Last updated
12/16/2019
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