Individual
JONI C NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD00031213
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010007199
BLUE SHIELD OF IDAHO
—
01
—
104202
LABOR & INDUSTRIES
WA
01
—
4330488
AETNA
—
05
—
8149726
—
WA
01
—
K4760
BLUE CROSS OF IDAHO
—
01
—
NI3252
ASURIS NW HEALTH
—
Enumeration date
10/19/2005
Last updated
12/31/2007
Update your record
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