Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LACY JO NICHOLS
Active Sole ProprietorLACY JO NICHOLS is a Neonatal Nurse Practitioner healthcare provider located in QUINCY, Illinois. NPI 1083361430 is currently active in the NPPES registry. Verify at CMS.
Neonatal Nurse Practitioner · QUINCY, IL
Registration Details
- NPI Number
- 1083361430
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 6, 2022 (4.4707770705855 yrs)
- Last Updated
- Apr 25, 2024
- Licenses
-
209028825 (IL)041369541 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
927 BROADWAY STQUINCY, IL, 623012719Browse IL providers · Browse ZIP 62301
- Phone
- 2172246423
- Fax
- 2172239370
- Primary Specialty
-
Neonatal Nurse Practitioner
363LN0000X
- Additional Specialty
- Registered Nurse
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.