Individual
LAURIE E NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1997 HIGHWAY 51 S, COVINGTON, TN 38019-3630
(901) 476-8967
Mailing address
1122 WALKER FIELD ROAD, MUNFORD, TN 38058-0000
(901) 840-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7091
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3909794
—
TN
Enumeration date
07/26/2006
Last updated
07/08/2007
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