Provider Demographics
NPI:1275827578
Name:NICHOLS, OKSANA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:OKSANA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-6707
Mailing Address - Country:US
Mailing Address - Phone:845-452-2120
Mailing Address - Fax:845-452-2104
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-6707
Practice Address - Country:US
Practice Address - Phone:845-452-2120
Practice Address - Fax:845-452-2104
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534061163W00000X
NY305768363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse