MEDICARE: ANDREW JAMES NICHOLS PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1207582	TX

General Provider Information

NPI Number	:	1144103631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW JAMES NICHOLS PMHNP

Provider Business Mailing Address
First Line	:	9600 N MOPAC EXPY STE 650
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-6507
Country	:	US
Telephone Number	:	801-821-2613
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 N MOPAC EXPY STE 650
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-6507
Country	:	US
Telephone Number	:	512-955-8474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	03/04/2026

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