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General NPI Number Information
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NPI Number | 1912589789
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Entity Type | Individual
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Provider Name | TINA NICHOLS
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Gender | Female
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1 HAMPTON RD STE A306
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City | EXETER
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State | NH
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Zip | 03833-4848
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Country | US
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Telephone | 603-929-1195
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Fax | 603-580-6047
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Provider Business Mailing Address
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Address Line | 4 ALUMNI DR
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City | EXETER
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State | NH
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Zip | 03833-2118
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Country | US
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Telephone | 603-929-1195
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Fax | 603-580-6047
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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 | 081003-23
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License Number State | NH
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