Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Crystal Jo Nichols, CFNP

Individual provider Family Nurse Practitioner · NPI 1659681328

Crystal Jo Nichols, CFNP is a Nurse Practitioner in Mantachie, Mississippi. Qualified in 2010, 16 years ago. Practices with Mantachie Rural Health Care, Inc, a 12-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
16
Licensed in
MS
In the registry since
2010
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Practice location Address checks out

285 Ivie Ln
Mantachie, MS 38855-9764
Phone: (662) 282-4197
Fax: (662) 282-5121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R870294 (MS)

Record details

NPI number1659681328
Entity typeIndividual (Type 1)
GenderFemale
Credentials CFNP
Sole proprietorNo
NPI enumeratedOctober 15, 2010
Last updated in NPPESOctober 23, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Mantachie Rural Health Care, Inc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mantachie