Nicholson, Teresa

Nicholson, Teresa is an sole proprietor health care provider with primary practice located at 104 Lakeshore Dr Ste A, Saint Marys GA 31558-3803. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Nicholson, Teresa can be contacted via phone (912) 882-7100.

Contact Information

Primary practice address
104 Lakeshore Dr Ste A Saint Marys GA 31558-3803
Phone: (912) 882-7100
Fax: (912) 882-9149
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X RN103935 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN103935 Georgia

Profile Details

NPI number 1184972887
LBN Legal business name Nicholson, Teresa
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2012
Last updated Dec 12th, 2016 - about 9 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 1184972887 NPPES
Georgia MEDICAID 003127951A
Georgia Other 202I422481
Georgia MEDICAID 003127951B

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