Provider Demographics
NPI:1407248602
Name:ANN NICHOLS AND ASSOCIATES
Entity Type:Organization
Organization Name:ANN NICHOLS AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-321-3789
Mailing Address - Street 1:8224 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-9096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8224 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-9096
Practice Address - Country:US
Practice Address - Phone:702-341-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care