Provider Demographics
NPI:1053877589
Name:NICHOLS, ROXANNE ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:ROXANNE
Middle Name:ELIZABETH
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 GREAT RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1006
Mailing Address - Country:US
Mailing Address - Phone:978-261-5226
Mailing Address - Fax:
Practice Address - Street 1:14 RED ACRE RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:MA
Practice Address - Zip Code:01775-1140
Practice Address - Country:US
Practice Address - Phone:508-395-2578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist