Provider Demographics
NPI:1821175910
Name:NICHOLS, LORNA LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:LEE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770719
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-0179
Mailing Address - Country:US
Mailing Address - Phone:352-873-4458
Mailing Address - Fax:352-873-8116
Practice Address - Street 1:7860 SW 103RD STREET ROAD
Practice Address - Street 2:BLDG 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-7089
Practice Address - Country:US
Practice Address - Phone:352-873-4458
Practice Address - Fax:352-873-8116
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1163592372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00260647OtherRR MEDICARE
FL304610900Medicaid
P52748Medicare UPIN
E7055SMedicare PIN