Individual
TALISHA NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1001 S 41ST ST E, MUSKOGEE, OK 74403-6253
(918) 781-6500
Mailing address
25860 S RIDGEVIEW DR, CLAREMORE, OK 74019-2399
(918) 352-1530
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
109621
OK
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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