Basic Information
| Provider Information | |||||||||
| NPI: | 1225449945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NICHOLS | ||||||||
| FirstName: | PAULA | ||||||||
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| Credential: | ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 73627 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772733627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814443278 | ||||||||
| FaxNumber: | 8322493861 | ||||||||
| Practice Location | |||||||||
| Address1: | 17350 ST LUKES WAY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773844100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814443278 | ||||||||
| FaxNumber: | 8322493861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2014 | ||||||||
| LastUpdateDate: | 05/15/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 689223 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.