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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427055011 | NPPES |
| Virginia | MEDICAID | 010104661 |
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