Individual
KACY LEIGH NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
885 SUMMIT CROSSING PLACE, GASTONIA, NC 28054-2193
(704) 316-4979
(704) 316-4978
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022-02982
NC
207Q00000X
Family Medicine Physician
260755
NC
Other
Enumeration date
04/20/2020
Last updated
08/24/2023
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