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NPI Code Detail

MEDICARE: JAMES NICHOLLS PHD

MEDICARE: JAMES NICHOLLS PHD
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
1103TC0700XClinical Psychologist863NH

General Provider Information

NPI Number : 1386753341
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES NICHOLLS PHD
Provider Business Mailing Address
First Line : PO BOX 2032
Second Line :
City : CONCORD
State : NH
Zip : 03302-2032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30 BOROUGH RD
Second Line :
City : PENACOOK
State : NH
Zip : 03303-1918
Country : US
Telephone Number : 603-753-9637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 08/11/2022

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