NPI

Crystal Jo Nichols

NPI 1659681328

Read from the NPPES registry on October 23, 2026.

Facts

Status
Active
Credential
C.F.N.P.
Type
Individual
Enumeration date
2010-10-15
Last updated
2014-10-23

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Specialties

Licenses

License MS
R870294

Location

Practice location
285 Ivie Ln
City
Mantachie MS
Postal code
38855-9764
Phone
(662) 282-4197

Medicare

PECOS
A PECOS enrollment row matches this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.

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Nearby

Other NPIs in Mantachie, MS. 44 records in the public file.

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