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Individual

DR. JENNIFER LYNN NICHOLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
2016025902
MO
2085P0229X
Pediatric Radiology Physician
35.093145
OH
2085P0229X
Pediatric Radiology Physician
57289
KY
2085P0229X
Pediatric Radiology Physician
Primary
DR.0076150
CO
2085R0202X
Diagnostic Radiology Physician
35.093145
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467617126
MO
05
7100517530
OH
05
ENROLLED
IL
Enumeration date
07/22/2008
Last updated
04/06/2026
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