Provider Demographics
NPI:1225628878
Name:NICHOLS, MEREDITH ELIZABETH (MED, LBS)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ELIZABETH
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MED, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLANE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4150
Mailing Address - Country:US
Mailing Address - Phone:484-678-4233
Mailing Address - Fax:
Practice Address - Street 1:5 PLANE HILL RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4150
Practice Address - Country:US
Practice Address - Phone:484-678-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002073174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist