Individual
SARA-NICOLE NICOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6905 PLANTATION RD, OCEAN SPRINGS, MS 39565-9002
(205) 441-5589
Mailing address
6905 PLANTATION RD, OCEAN SPRINGS, MS 39565-9002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN704920
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
10313-33
WI
367500000X
Certified Registered Nurse Anesthetist
RN2341791
MA
367500000X
Certified Registered Nurse Anesthetist
RN704920
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110001680A
—
MA
Enumeration date
03/19/2018
Last updated
04/16/2026
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