Individual
REGGIE ALLEN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3615 N PRINCE VILLAGE PL STE 121, TUCSON, AZ 85719-2034
(520) 225-0584
Mailing address
7306 S VIA CABANA, TUCSON, AZ 85756-8358
(928) 266-6633
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
7631
AZ
2084P0802X
Addiction Psychiatry Physician
7631
AZ
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
12/15/2019
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