Provider Demographics
NPI:1275653008
Name:NICHOLSON, ANNE THUTT (MED)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:THUTT
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NC
Mailing Address - Zip Code:28788-0219
Mailing Address - Country:US
Mailing Address - Phone:828-586-9094
Mailing Address - Fax:
Practice Address - Street 1:G30 MCKEE
Practice Address - Street 2:WESTERN CAROLINA UNIVERSITY
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723-9646
Practice Address - Country:US
Practice Address - Phone:828-227-7251
Practice Address - Fax:828-227-7457
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist