Individual
DR. KATRINA NICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-3229
(859) 257-1000
(859) 257-1342
Mailing address
2312 ALEXANDRIA DR, LEXINGTON, KY 40504-3229
(859) 276-5344
(859) 296-0362
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39009
KY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
39009
KY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
39009
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64101462
—
KY
Enumeration date
05/05/2006
Last updated
08/08/2022
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