Individual
JOHNATHAN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1103 NW 30TH AVE, GAINESVILLE, FL 32609-2812
(352) 278-0976
Mailing address
1103 NW 30TH AVE, GAINESVILLE, FL 32609-2812
(352) 278-0976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9530292
FL
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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