Healthcare Provider Details

I. General information

NPI: 1275223943
Provider Name (Legal Business Name): HANNAH NICHOLS RN, MSN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 MONTGOMERY AVE SUITE 201
NARBERTH PA
19072
US

IV. Provider business mailing address

509 MULBERRY LN
HAVERFORD PA
19041-1913
US

V. Phone/Fax

Practice location:
  • Phone: 610-667-0650
  • Fax: 610-667-1481
Mailing address:
  • Phone: 626-676-6119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP035760
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: