Individual
WHITNEY WALLACE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
201 ALBERT AVE, SCOTT CITY, KS 67871
(620) 872-2187
(620) 872-7193
Mailing address
201 ALBERT AVE, SCOTT CITY, KS 67871
(620) 872-2187
(620) 872-7193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-38325
KS
207Q00000X
Family Medicine Physician
9408294
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201171720A
—
KS
Enumeration date
06/20/2014
Last updated
12/29/2017
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