Provider Demographics
NPI:1346587599
Name:NICHOLS, MARANDA ELIZABETH (PA-C, MPH)
Entity Type:Individual
Prefix:MISS
First Name:MARANDA
Middle Name:ELIZABETH
Last Name:NICHOLS
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Gender:F
Credentials:PA-C, MPH
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Mailing Address - Street 1:4334 E HIGHLAND DR
Mailing Address - Street 2:STE A
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6621
Mailing Address - Country:US
Mailing Address - Phone:870-802-0012
Mailing Address - Fax:870-972-5140
Practice Address - Street 1:4334 E HIGHLAND DR
Practice Address - Street 2:STE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6621
Practice Address - Country:US
Practice Address - Phone:870-802-0012
Practice Address - Fax:870-972-5140
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
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Provider Licenses
StateLicense IDTaxonomies
AR363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical