Nichols, Thedra E

Nichols, Thedra E is an individual health care provider with primary practice located at 1215 Lee St , Charlottesville VA 22908-0816. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Nichols, Thedra E can be contacted via phone (434) 924-0000.

Contact Information

Primary practice address
1215 Lee St Charlottesville VA 22908-0816
Phone: (434) 924-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0024166152 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024166152 Virginia

Profile Details

NPI number 1427055011
LBN Legal business name Nichols, Thedra E
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Apr 17th, 2023 - about last year

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 1427055011 NPPES
Virginia MEDICAID 010104661

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