Provider Demographics
NPI:1992530950
Name:NICHOLS, NATALIE CAROL (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CAROL
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14380 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-2839
Mailing Address - Country:US
Mailing Address - Phone:804-350-4630
Mailing Address - Fax:
Practice Address - Street 1:7501 LEAD MINE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5847
Practice Address - Country:US
Practice Address - Phone:919-870-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist