Provider Demographics
NPI:1982235966
Name:NICHOLS, ELIZABETH WINTER
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WINTER
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2218
Mailing Address - Country:US
Mailing Address - Phone:415-518-5425
Mailing Address - Fax:
Practice Address - Street 1:166 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2218
Practice Address - Country:US
Practice Address - Phone:415-518-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator