Most Relevant Information
Provider Data
| NPI Number: | 1003390832 |
| Provider Name: | STEPHANIE NICHOLSON |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LPN.169214.MEDS-IV |
Most Important Dates
| Enumeration Date: | 09/18/2018 |
| Last Updated: | 09/18/2018 |
Provider Practice Location
765 PIERCE DR
COLUMBUS
OH
432232425
Practice Location Phone/Fax
| Phone: | 6142231650 |
| Fax: |
Provider Mailing Location
1022 QUARRY PARK DR
REYNOLDSBURG
OH
430689790
Provider Mailing Phone/Fax
| Phone: | 6142880819 |
| Fax: |