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General NPI Number Information
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NPI Number | 1982995940
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Entity Type | Individual
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Provider Name | JEANINE LOUISE NICHOLS CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/26/2011
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 404 SPRING ST
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City | DEL RIO
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State | TX
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Zip | 78840
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Country | US
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Telephone | 832-600-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 TWIN OAKS BLVD
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City | KEMAH
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State | TX
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Zip | 77565-2152
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Country | US
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Telephone | 832-600-9703
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNA213027
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 822385
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP122211
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License Number State | TX
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