Provider Demographics
NPI:1376389130
Name:NICHOLS, TAYLOR ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:470 WRENN CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3056
Mailing Address - Country:US
Mailing Address - Phone:410-713-2099
Mailing Address - Fax:
Practice Address - Street 1:12997 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-8352
Practice Address - Country:US
Practice Address - Phone:757-369-9446
Practice Address - Fax:757-369-9554
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant