Individual
PATRICIA DIANE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
104 W. ROCHESTER STREET, AKRON, IN 46910
(574) 372-3800
Mailing address
PO BOX 966, WARSAW, IN 46580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28061461A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200078320
—
IN
Enumeration date
06/15/2006
Last updated
08/28/2009
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