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

Lacy Jo Nichols

Individual provider Neonatal Nurse Practitioner · NPI 1083361430

Lacy Jo Nichols is a Neonatal Nurse Practitioner in Quincy, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2022
Specialties on file
2

Practice location Address checks out

927 Broadway St
Quincy, IL 62301-2719
Phone: (217) 224-6423
Fax: (217) 223-9370
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neonatal Nurse Practitioner (primary) Taxonomy 363LN0000X · Licence 209028825 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041369541 (IL)

Record details

NPI number1083361430
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 6, 2022
Last updated in NPPESApril 25, 2024
Certification dateApril 25, 2024
Mailing address1005 Broadway St, Quincy, IL 62301-2834