Individual
DR. KIMBERLY MARIE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 STONEFOREST DR, SUITE 320, WOODSTOCK, GA 30189-4880
(770) 516-5199
(770) 516-5199
Mailing address
100 STONEFOREST DR, SUITE 320, WOODSTOCK, GA 30189-4880
(770) 516-5199
(770) 516-5199
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
68082
GA
207ZD0900X
Dermatopathology (Pathology) Physician
68082
GA
Other
Enumeration date
07/01/2008
Last updated
05/19/2015
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