Individual provider · Type 1 NPI

Colleen Diane Nichols, CPNP-PC

Pediatric Nurse Practitioner · St. Louis, MO

NPI number 1952935405 Active

Practice location

1465 S Grand Blvd
St. Louis, MO 63104-1003

Mailing address

1554 Heritage Valley Dr
High Ridge, MO 63049-1169

Other practice locations

  • 1 Childrens Pl, St. Louis, MO 63110-1002 · (314) 454-3250

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X2020006145 (MO)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1952935405

Colleen Diane Nichols, CPNP-PC's National Provider Identifier is 1952935405, issued on Feb 24, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Louis, MO. The record was last updated on Nov 3, 2021.