CHANTAL MARIE NICHOLS (NPI# 1437780764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437780764 |
| Entity Type | Individual |
| Full Name | CHANTAL MARIE NICHOLS |
| Credential | NP |
| Practice Address |
630 N Main St Williston FL 32696-1705 |
| Mailing Address |
23343 Nw County Road 236 High Springs FL 32643-9669 |
| Practice Telephone | 3525280587 |
| Practice Fax Number | 3525284834 |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | APRN11005897 | FL | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11005897 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23476 W Us Hwy, High Springs, FL 32643 | 3864540568 | 3522247899 |
| 911 S Main St, Trenton, FL 326933239 | 3524632374 |
| Street Address |
630 N MAIN ST |
| City | WILLISTON |
| State | FL |
| Zip Code | 32696-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902879158 | Stephen S Falkowski | Family Medicine | 630 N Main St, Williston, FL 32696-1705 | 2006-02-08 |
| 1174181333 | Tonya L Jones | Nurse Practitioner | 630 N Main St, Williston, FL 32696-1705 | 2019-06-03 |
| 1730619594 | Catherine Alexandra Koubek | Dentist | 630 N Main St, Williston, FL 32696-1705 | 2017-06-14 |
| 1396280103 | Shonverea S Robinson | Registered Nurse | 630 N Main St, Williston, FL 32696-1705 | 2017-01-03 |
| 1659620409 | Carmen I Tozzo Pa | Psychologist | 630 N Main St, Williston, FL 32696-1705 | 2012-09-06 |
| 1508154956 | Tamara Michelle Wood | Physician Assistant | 630 N Main St, Williston, FL 32696-1705 | 2011-07-19 |
| 1720313950 | Elizabeth Eddins Thompson | Nurse Practitioner | 630 N Main St, Williston, FL 32696-1705 | 2009-10-06 |
| 1255577631 | Trenton Medical Center Inc | Clinic/Center | 630 N Main St, Williston, FL 32696-1705 | 2009-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962060939 | Quick Care Med LLC | Non-Pharmacy Dispensing Site | 517 W Noble Ave, Williston, FL 32696 | 2019-06-04 |
| 1346770930 | Michelle Yvette Dempsey | Home Health Aide | 931 Ne 207th Ave, Williston, FL 32696 | 2017-06-15 |
| 1801157185 | Pratibha Lumb | Family Medicine | 630 N. Main Street, Williston, FL 32696 | 2012-06-04 |
| 1821261306 | Raymond T Webber | Dentist | 610 Sw 1st Ave, Williston, FL 32696 | 2008-04-07 |
| 1003912635 | Jeremie Joseph Young | General Practice | 125 Sw 7th Street, Williston, FL 32696 | 2006-09-14 |
| 1073514543 | Kolli Prabhakara Reddy | Family Medicine | 520 Sw 5th Ave, Williston, FL 32696 | 2005-08-09 |
| 1578584884 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-07-21 |
| 1841631249 | Lawrence C Rush Jr. | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2013-07-13 |
| 1952401648 | Teresa Sever | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-09-23 |
| 1497060784 | Priscilla Smith | Social Worker | 18990 Ne 49th St, Williston, FL 32696-1555 | 2010-08-11 |
| Find all providers in zip 32696 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740747047 | Camilla Dawn Pace | Nurse Practitioner | 37 S Main St Ste A, Williston, FL 32696-2681 | 2019-02-23 |
| 1417277500 | Tara Blue Meyer | Nurse Practitioner | 353 Blair Pk. Rd., Uvm Medical Center - PCim/williston, Williston, VT 05495 | 2010-06-11 |
| 1881656361 | Rita Laverne Long Arrington | Nurse Practitioner | 130 Sw 7th Street, Williston, FL 32696-2404 | 2006-04-03 |
| 1487251930 | Elizabeth Coulson | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2020-10-07 |
| 1740822584 | Anna Elizabeth Wolf | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2019-10-14 |
| 1174181333 | Tonya L Jones | Nurse Practitioner | 630 N Main St, Williston, FL 32696-1705 | 2019-06-03 |
| 1831685767 | Mirsada Nurkanovic | Nurse Practitioner | 586 Oak Hill Rd, Williston, VT 05495-7103 | 2018-07-03 |
| 1093219685 | Nana Oforiwaa Boateng | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2018-03-20 |
| 1831606326 | Lily Stolberg | Nurse Practitioner | 586 Oak Hill Rd, Williston, VT 05495-7103 | 2018-01-05 |
| 1669901591 | Tiah Elizabeth Rigby | Nurse Practitioner | 1301 15th Ave W, Williston, ND 58801-3821 | 2017-06-05 |
| Find all providers in WILLISTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.