Individual
KITRA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Mailing address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18366
SC
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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