Individual
MISS LISA KAY NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
721 65TH ST N, ST PETERSBURG, FL 33710-6935
(727) 343-2795
Mailing address
721 65TH ST N, ST PETERSBURG, FL 33710-6935
(727) 343-2795
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN3139472
FL
Other
Enumeration date
02/17/2007
Last updated
07/09/2007
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