Provider Demographics
NPI:1427606490
Name:NICHOLS, ASHLEY N (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:11 PARK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3031
Mailing Address - Country:US
Mailing Address - Phone:989-293-4517
Mailing Address - Fax:
Practice Address - Street 1:1 ELM ST
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-1301
Practice Address - Country:US
Practice Address - Phone:802-228-8867
Practice Address - Fax:802-228-5170
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2020-08-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant