Individual
JANET NICKOLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2300 E MILL PLAIN BLVD, VANCOUVER, WA 98661-4332
(360) 901-0170
(360) 254-3552
Mailing address
2300 E MILL PLAIN BLVD, VANCOUVER, WA 98661-4332
(360) 901-0170
(360) 254-3552
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
000039125N6 PMHNP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004009
WA
Other
Enumeration date
12/09/2005
Last updated
07/23/2007
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