Individual
TRACEY RENEE NICHOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
1307 FORTINO BLVD STE A, PUEBLO, CO 81008-2377
(719) 582-1010
(719) 582-1010
Mailing address
PO BOX 296, BEULAH, CO 81023-0296
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU0001916
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417489519
—
CO
Enumeration date
10/31/2017
Last updated
01/28/2026
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