IndividualActive
Amanda Nichols
NPI 1679336630 · Registered Nurse · Mesa, AZ
Provider details
- NPI number
- 1679336630
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 24725391 (AZ)
Specialties & taxonomies
Nursing Service Providers
Practice location
738 S Longmore
Mesa, AZ 85202-1908
Phone: (480) 472-4360
Fax: (480) 472-4350
Approximate (ZIP-level) locationGet directions
Mailing address
745 N 25th St
Mesa, AZ 85213-6898
Registry dates
- Enumerated
- 2024-02-02
- Last updated
- 2024-02-05
- Certified
- 2024-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.