Individual
ANNA ELIZABETH NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
15945 CLAYTON RD STE 120, BALLWIN, MO 63011-2490
(636) 256-5000
Mailing address
15945 CLAYTON RD STE 120, BALLWIN, MO 63011-2490
(636) 256-5000
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2023019231
MO
Other
Enumeration date
06/14/2023
Last updated
08/30/2023
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