Provider Demographics
NPI:1649160722
Name:NICHOLS, YVETTE JONQUIL (RN)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:JONQUIL
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 COLCHESTER DR SE UNIT 248
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98353-9815
Mailing Address - Country:US
Mailing Address - Phone:360-510-7644
Mailing Address - Fax:
Practice Address - Street 1:614 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4614
Practice Address - Country:US
Practice Address - Phone:360-337-7116
Practice Address - Fax:360-337-7203
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00101275163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse