Provider Demographics
NPI:1154074359
Name:NICHOLS HEARING AND AUDIOLOGY
Entity Type:Organization
Organization Name:NICHOLS HEARING AND AUDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:336-842-3437
Mailing Address - Street 1:3640 WESTGATE CENTER CIR STE B
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3056
Mailing Address - Country:US
Mailing Address - Phone:336-842-3437
Mailing Address - Fax:
Practice Address - Street 1:3640 WESTGATE CENTER CIR STE B
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3056
Practice Address - Country:US
Practice Address - Phone:336-842-3437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Single Specialty