Individual
KATHLEEN NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-5315
(614) 722-3033
Mailing address
DEPT 781676, PO BOX 78000, DETROIT, MI 48278-1676
(614) 722-5315
(614) 722-3033
Taxonomy
Speciality
Code
Description
License number
State
207ZP0213X
Pediatric Pathology Physician
Primary
35074834N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000214175
BCBS
OH
05
—
2161020
—
OH
01
—
7581412
AETNA
—
Enumeration date
12/01/2005
Last updated
01/30/2015
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