Individual
KAITLIN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-5400
(352) 273-7584
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
286458
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123344400
—
FL
Enumeration date
04/25/2017
Last updated
08/13/2024
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