Individual
JANICE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3762 DURHAM RD STE A, ROXBORO, NC 27573-2741
(336) 330-0400
(336) 330-0031
Mailing address
3762 DURHAM RD STE A, ROXBORO, NC 27573-2741
(336) 330-0400
(336) 330-0031
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA-442
ME
363A00000X
Physician Assistant
Primary
101575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780763524
—
NC
Enumeration date
11/03/2006
Last updated
05/05/2021
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