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NPI 1225529415

NPI 1225529415 : SILVER L NICHOLS : WINNEMUCCA, NV

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General NPI Number Information
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    NPI Number           |    1225529415
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    Entity Type          |    Individual 
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    Provider Name        |    SILVER L NICHOLS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/23/2018
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    Last Update Date     |    05/23/2018
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Provider Practice Location Address
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    Address Line         |    118 E HASKELL ST 
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    City                 |    WINNEMUCCA
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    State                |    NV
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    Zip                  |    89445-3247
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    Country              |    US
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    Telephone            |    775-722-6720
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    680 WESO ST 
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    City                 |    WINNEMUCCA
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    State                |    NV
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    Zip                  |    89445-3746
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    Country              |    US
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    Telephone            |    775-722-6720
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    146L00000X
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    Taxonomy Name        |    Paramedic
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    License Number       |    75323
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    License Number State |    NV
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