Provider Demographics
NPI:1962711648
Name:NICHOLSON, SYLVIA QUEVEDO (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:QUEVEDO
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W IRVINGTON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706
Mailing Address - Country:US
Mailing Address - Phone:520-294-1740
Mailing Address - Fax:
Practice Address - Street 1:315 W IRVINGTON RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-3050
Practice Address - Country:US
Practice Address - Phone:520-294-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3808363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily