Provider Demographics
NPI:1760782551
Name:NICHOLSON, VERONICA JEAN
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:JEAN
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ROCK SPRINGS DR APT 2030
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3149
Mailing Address - Country:US
Mailing Address - Phone:702-812-2374
Mailing Address - Fax:
Practice Address - Street 1:2300 ROCK SPRINGS DR APT 2030
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3149
Practice Address - Country:US
Practice Address - Phone:702-812-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner