Individual
TRISHA JO NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1615 MLK BLVD, MALVERN, AR 72104-2233
(501) 332-5236
(501) 620-5109
Mailing address
125 DONS WAY, HOT SPRINGS, AR 71913-6478
(501) 624-7111
(501) 620-5109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R73728
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116399726
—
AR
Enumeration date
03/03/2010
Last updated
03/12/2010
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