Individual
MS. CYNTHIA D NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
(727) 767-8420
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
(727) 767-8420
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN 2716692
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
2716692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026268600
—
FL
01
—
AZ378Z
MEDICARE
FL
Enumeration date
07/21/2008
Last updated
08/08/2016
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