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NPI Code Detail

MEDICARE: RHYANNON PAIGE NICHOLS

MEDICARE: RHYANNON PAIGE NICHOLS
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
1106S00000XBehavior TechnicianR-15955LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123-252105OTHERTXBACB

General Provider Information

NPI Number : 1659085694
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHYANNON PAIGE NICHOLS
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 855-832-6727
Fax Number :
Provider Business Practice Location Address
First Line : 139 JAMES COMEAUX RD STE B,
Second Line : BOX 818
City : LAFAYETTE
State : LA
Zip : 70508-3376
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2023
Last Update Date : 04/24/2024

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Directions to “ RHYANNON PAIGE NICHOLS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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