Provider Demographics
NPI:1497070742
Name:NICHOLSON, FRANCIS WILLIAM (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:WILLIAM
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PEER SPECIALIST
Mailing Address - Street 1:PO BOX 1868
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-1868
Mailing Address - Country:US
Mailing Address - Phone:307-732-1161
Mailing Address - Fax:307-732-1191
Practice Address - Street 1:640 E BROADWAY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-1868
Practice Address - Country:US
Practice Address - Phone:307-732-1161
Practice Address - Fax:307-732-1191
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist