Nicols, Amanda Gray
Nicols, Amanda Gray is an individual health care provider with primary practice located at 501 Marshall Street Suite 400, Jackson MS 39202-1687. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Nicols, Amanda Gray can be contacted via phone (601) 354-0869.Contact Information
Primary practice address
501 Marshall Street Suite 400
Jackson MS 39202-1687
Phone: (601) 354-0869
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 20191 | Mississippi |
Profile Details
| NPI number | 1720273535 |
|---|---|
| LBN Legal business name | Nicols, Amanda Gray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2007 |
| Last updated | Nov 19th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720273535 | NPPES |
| Mississippi | MEDICAID | 08221030 |
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