Provider Demographics
NPI:1487689782
Name:NICHOLS, GLORIA JEAN (RNC, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:JEAN
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RNC, WHNP
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Mailing Address - Street 1:20109 REGENCY RUN
Mailing Address - Street 2:
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2346
Mailing Address - Country:US
Mailing Address - Phone:210-651-1103
Mailing Address - Fax:210-616-9304
Practice Address - Street 1:7711 LOUIS PASTEUR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3415
Practice Address - Country:US
Practice Address - Phone:210-692-9500
Practice Address - Fax:210-616-9304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX241589363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology