Denise R Nichols

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

100435 Issued in MO

Practice address

1110 N Westwood Blvd
Poplar Bluff, MO 63901-3336

Phone

(573) 785-6707

Fax

(573) 785-0336

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124194493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013336",
            "telephone_number": "573-785-6707",
            "fax_number": "573-785-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013336",
            "telephone_number": "573-785-6707",
            "fax_number": "573-785-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "DENISE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "100435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANG PATH CERT",
            "identifier": "100435",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Newman, FNP
• Bethany Alyssa Newman
• Claressia Nicole Newman
• Tony N Nguyen, DMD
• Shaun David Nibbe, DC
• Hattie Miranda Nichols
• Janice Nicholson, RN
• Roland Fokwen Njoh, M.D.
• NLH Enterprise LLC
• Lynda C Nobles

• Speech-Language Pathologist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.