| Patricia M Nichols | |
|
502 S 4th St Laramie WY 82070-3704 | |
| (307) 755-1000 | |
| Not Available |
| Full Name | Patricia M Nichols |
|---|---|
| Speciality | Social Worker |
| Location | 502 S 4th St, Laramie, Wyoming |
| Authorized Official Name and Position | Patricia Nichols (THERAPIST) |
| Authorized Official Contact | 3077551000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia M Nichols 502 S 4th St Laramie WY 82070-3704 Ph: (307) 755-1000 | Patricia M Nichols 502 S 4th St Laramie WY 82070-3704 Ph: (307) 755-1000 |
| NPI Number | 1609512086 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 05/09/2022 |
| Certification Date | 05/09/2022 |
| Medicare PECOS PAC ID | 4284012659 |
|---|---|
| Medicare Enrollment ID | O20220526001530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609512086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia M Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407205636 PECOS PAC ID: 6002294477 Enrollment ID: I20220526001590 |
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