Individual
JESSICA SHARON NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 TRANS MOUNTAIN RD STE A, EL PASO, TX 79911
(915) 215-8400
(915) 612-9254
Mailing address
440 RAYNOLDS ST # 51015, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA11048
TX
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
PA11048
TX
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
11/09/2016
Last updated
09/18/2019
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