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Individual

GAY NICHOLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
413 W CLINTON ST, ITHACA, NY 14850-5266
(607) 342-1630
Mailing address
413 W CLINTON ST, ITHACA, NY 14850-5266
(607) 342-1630

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F001039
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02240673
NY
Enumeration date
11/28/2006
Last updated
10/14/2015
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