Individual
DR. KATHLEEN A NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13055 W MCDOWELL RD, SUITE E-106, AVONDALE, AZ 85392-6449
(623) 975-8400
(623) 935-2975
Mailing address
13055 W MCDOWELL RD, SUITE E-106, AVONDALE, AZ 85392-6449
(623) 975-8400
(623) 935-2975
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AZ26993
AZ
208000000X
Pediatrics Physician
AZ26993
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
517675
—
AZ
Enumeration date
08/11/2006
Last updated
06/08/2015
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