Nichols, Beverly

Nichols, Beverly is an individual health care provider with primary practice located at 12510 Queens Blvd , Kew Gardens NY 11415-1519. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Home Health, Nursing Service Related Providers / Home Health Aide, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Nichols, Beverly can be contacted via phone (718) 459-5592.

Contact Information

Primary practice address
12510 Queens Blvd Kew Gardens NY 11415-1519
Phone: (718) 459-5592
Fax: (718) 459-6047
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Home Health 364SH0200X 9569L001 New York
Nursing Service Related Providers / Home Health Aide 374U00000X 9569L001 New York
Other Service Providers / Specialist 174400000X 9569L001 New York

Profile Details

NPI number 1255403242
LBN Legal business name Nichols, Beverly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Dec 13th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255403242 NPPES
New York MEDICAID 01761260

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