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General NPI Number Information
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NPI Number | 1316829252
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Entity Type | Individual
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Provider Name | JADA KIERRA NICHOLS APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1612 E COUNTY LINE RD
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City | RIDGELAND
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State | MS
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Zip | 39157-1906
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Country | US
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Telephone | 601-429-1160
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Fax |
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Provider Business Mailing Address
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Address Line | 293 ASHWORTH CIR
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City | MADISON
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State | MS
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Zip | 39110-1800
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Country | US
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Telephone | 601-813-1103
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 907626
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License Number State | MS
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