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NPI Code Detail

MEDICARE: LAUREN ANNE NICHOLLS M.D.

MEDICARE:   LAUREN ANNE NICHOLLS  M.D.
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
1208000000XPediatrics Physician51515AZ

General Provider Information

NPI Number : 1326238502
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ANNE NICHOLLS M.D.
Provider Business Mailing Address
First Line : BOX 245073, 1501 N. CAMPBELL AVE.
Second Line : RM 5341C BANNER UNIVERSITY MEDICAL CENTER-TUCSON
City : TUCSON
State : AZ
Zip : 85724-5073
Country : US
Telephone Number : 520-626-6040
Fax Number :
Provider Business Practice Location Address
First Line : 1501 N. CAMPBELL AVE.
Second Line : RM 5341C BANNER UNIVERSITY MEDICAL CENTER-TUCSON
City : TUCSON
State : AZ
Zip : 85724-5073
Country : US
Telephone Number : 520-626-6040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2007
Last Update Date : 03/22/2016

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Directions to “ LAUREN ANNE NICHOLLS M.D.” Practice Location

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