Provider Demographics
NPI:1023659380
Name:NICHOLS, NADINE E (OWNER,MANAGER)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:E
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:OWNER,MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 BIRDSONG ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37915-2301
Mailing Address - Country:US
Mailing Address - Phone:865-801-8866
Mailing Address - Fax:
Practice Address - Street 1:1734 BIRDSONG ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37915-2301
Practice Address - Country:US
Practice Address - Phone:865-801-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty