IndividualActive
Jourdan Nichols
NPI 1154715316 · Early Intervention Provider Agency · Fulton, MO
Provider details
- NPI number
- 1154715316
- Entity type
- Individual
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2015001098 (MO)
Mailing address
2 Hornet Dr
Fulton, MO 65251-2732
Registry dates
- Enumerated
- 2015-03-26
- Last updated
- 2015-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.