person
Crystal Jo Nichols, CFNP
Family Nurse Practitioner in Mantachie, Mississippi
NPI 1659681328

Crystal Jo Nichols is a Family Nurse Practitioner based in Mantachie, MS and is specialized in Family. Crystal Jo Nichols practices in Mantachie, MS and has the professional credentials of CFNP. The NPI Number for Crystal Jo Nichols is 1659681328 and holds a License No. R870294 (Mississippi).

The current practice location address for Crystal Jo Nichols is 285 Ivie Ln, Mantachie, MS and can be reached out via phone at 662-282-4197 and via fax at 662-282-5121.

Location: 285 Ivie Ln, Mantachie, MS, 38855-9764
person
Provider Profile Details
NPI Number
1659681328
Provider Name
Crystal Jo Nichols
Credential
CFNP
Provider Entity Type
Individual
Gender
Female
Address
285 Ivie Ln, Mantachie, MS, 38855-9764
Phone Number
662-282-4197
Fax Number
662-282-5121
Provider Enumeration Date
10/15/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05372791 05 MS
institution
Provider Business Practice Location Address Details
Address
285 Ivie Ln
City
State
Zip
38855-9764
Phone Number
662-282-4197
Fax Number
662-282-5121
person
Provider Business Mailing Address Details
Address
285 Ivie Ln
City
State
Zip
38855-9764
Phone Number
662-282-4197
Fax Number
662-282-5121
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R870294 (Mississippi)
Definition
Definition to come...
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