Individual
MR. MARLON D NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5485 PALM ST, LAS VEGAS, NV 89120-2110
(702) 619-9948
Mailing address
5485 PALM ST, LAS VEGAS, NV 89120-2110
(702) 619-9948
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
823640
NV
Other
Enumeration date
08/22/2022
Last updated
10/10/2024
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