Individual
MRS. DEANNA ARLENE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
200 N CRAWFORD ST STE 3, TOMPKINSVILLE, KY 42167-1617
(270) 407-5052
(270) 407-5053
Mailing address
PO BOX 669, 200 N CRAWFORD STREET SUITE 3, TOMPKINSVILLE, KY 42167-0669
(270) 407-5052
(270) 407-5053
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004997
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103764
RN LISCENSE
KY
Enumeration date
10/23/2006
Last updated
06/30/2014
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