Provider Demographics
NPI:1013346881
Name:NICHOLS, TINA (PHD, CNIM)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PHD, CNIM
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:FIORELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 N CENTRAL EXPY UNIT 2586
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-0139
Mailing Address - Country:US
Mailing Address - Phone:855-864-4322
Mailing Address - Fax:
Practice Address - Street 1:550 N CENTRAL EXPY UNIT 2586
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-0139
Practice Address - Country:US
Practice Address - Phone:855-864-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic