Individual
MAUREEN NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
51 N 39TH ST, 4 PHI, PHILADELPHIA, PA 19104-2640
(215) 662-9189
(856) 216-7148
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9189
(215) 243-4612
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ00332400
NJ
363L00000X
Nurse Practitioner
26NR09306000
NJ
363L00000X
Nurse Practitioner
Primary
APPLIED
PA
Other
Enumeration date
10/25/2010
Last updated
04/09/2020
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