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Individual

LORNA LEE NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
7860 SW 103RD STREET ROAD, BLDG 100, OCALA, FL 34476-7089
(352) 873-4458
(352) 873-8116
Mailing address
PO BOX 770719, OCALA, FL 34477-0179
(352) 873-4458
(352) 873-8116

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
1163592
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
304610900
FL
01
P00260647
RR MEDICARE
FL
Enumeration date
11/01/2006
Last updated
12/17/2009
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