Individual
KELLY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2601 KENTUCKY AVE, SUITE 300, PADUCAH, KY 42003-3817
(270) 443-5564
(270) 443-5549
Mailing address
2605 KENTUCKY AVE, SUITE 306, PADUCAH, KY 42003-3800
(270) 415-7653
(270) 575-8359
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3010752
KY
Other
Enumeration date
09/23/2016
Last updated
12/07/2020
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