Provider Demographics
NPI:1417793860
Name:NICHOLS, ALEXIS (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4306
Mailing Address - Country:US
Mailing Address - Phone:430-200-4350
Mailing Address - Fax:866-337-1615
Practice Address - Street 1:6010 TRINITY HTS
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-8318
Practice Address - Country:US
Practice Address - Phone:501-621-2770
Practice Address - Fax:866-337-1615
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR226360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily