Nichols, Gary Glenn

Nichols, Gary Glenn is an individual health care provider with primary practice located at 1404 Willow Ln , North Wilkesboro NC 28659-3584. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Nichols, Gary Glenn can be contacted via phone (336) 667-0335.

Contact Information

Primary practice address
1404 Willow Ln North Wilkesboro NC 28659-3584
Phone: (336) 667-0335
Fax: (336) 667-4434
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 100253 North Carolina

Profile Details

NPI number 1316936156
LBN Legal business name Nichols, Gary Glenn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Aug 1st, 2017 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316936156 NPPES
North Carolina Other 2750028C MEDICARE PTAN, INDIVIDUAL
North Carolina MEDICAID 5905127 MEDICARE PTAN, INDIVIDUAL
North Carolina Other 203994F MEDICARE PTAN, INDIVIDUAL
North Carolina Other 2335816 MEDICARE PTAN, INDIVIDUAL

Popular Providers