Provider Demographics
NPI:1902130081
Name:NICHOLLS, ANA CRISTINA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CRISTINA
Last Name:NICHOLLS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:CRISTINA
Other - Last Name:LOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:160 RIVER BEND DR STE C
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-9390
Mailing Address - Country:US
Mailing Address - Phone:828-572-7305
Mailing Address - Fax:828-330-0950
Practice Address - Street 1:160 RIVER BEND DR STE C
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-9390
Practice Address - Country:US
Practice Address - Phone:828-572-7305
Practice Address - Fax:828-330-0950
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103094363AM0700X, 363AS0400X
NC0010-13557363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical