Individual
KRISTI LYNN NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4525 CAMERON VALLEY PKWY, SUITE 1500, CHARLOTTE, NC 28211-3546
(704) 512-6240
(704) 512-6241
Mailing address
PO BOX 601692, CHARLOTTE, NC 28260-1692
(704) 512-6240
(704) 512-6241
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-00999
NC
Other
Enumeration date
08/27/2007
Last updated
02/01/2011
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