Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD467491 | PA |
NPI | 1508244377 |
---|---|
Provider Name | Lauren Nicholls |
First Address | Danville, PA 17822-4903 |
Second Address | Scranton, PA 18510-2369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2015 |
Last Update Date | 27/08/2020 |