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General NPI Number Information
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NPI Number | 1528485471
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Entity Type | Individual
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Provider Name | CHRISTINA M NICHOLSON PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 3737 WOODLAND AVE SUITE 410
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City | WEST DES MOINES
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State | IA
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Zip | 50266
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Country | US
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Telephone | 155-006-0825
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Fax | 515-337-9142
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Provider Business Mailing Address
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Address Line | 3737 WOODLAND AVE SUITE 410
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City | WEST DES MOINES
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State | IA
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Zip | 50266-4329
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Country | US
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Telephone | 515-500-6082
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Fax | 515-337-9142
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G105648
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License Number State | IA
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