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General NPI Number Information
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NPI Number | 1538167523
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Entity Type | Individual
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Provider Name | TONYA B NICHOLSON C.N.M.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 2400 BELLEVUE RD ERIN OFFICE SUITE 26
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City | DUBLIN
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State | GA
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Zip | 31021-2885
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Country | US
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Telephone | 478-275-1304
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 SHAMROCK DR
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City | DUBLIN
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State | GA
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Zip | 31021-3096
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Country | US
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Telephone | 478-998-3616
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | ARNP-9165179
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 131379
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License Number State | GA
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