Individual provider · Type 1 NPI
Lacy Jo Nichols
Neonatal Nurse Practitioner · Quincy, IL
NPI number
1083361430
Active
Practice location
927 Broadway St
Quincy, IL 62301-2719
Fax (217) 223-9370
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Neonatal Nurse Practitioner Primary | 363LN0000X | 209028825 (IL) |
| Registered Nurse | 163W00000X | 041369541 (IL) |
Neonatal Nurse Practitioner: Definition to come...
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About NPI 1083361430
Lacy Jo Nichols's National Provider Identifier is 1083361430, issued on Mar 6, 2022. The primary taxonomy on file is Neonatal Nurse Practitioner (363LN0000X), and the practice location is in Quincy, IL. The record was last updated on Sep 24, 2026.