Provider Demographics
NPI:1386940237
Name:NICHOLS, TAMMY SUE (RN)
Entity type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:SUE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-1306
Mailing Address - Country:US
Mailing Address - Phone:585-335-5967
Mailing Address - Fax:
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1122
Practice Address - Country:US
Practice Address - Phone:585-243-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY487013251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health