SearchGeorgia164W00000X

Phedeline Nicholas

NPI 1750557187 · on the registry since 2008 · sole proprietor

Practice

Address
1746 Pleasant Hill Trl
Lithonia, GA 30058
Phone
(718) 519-7672

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2008-05-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia