Individual
KIRSTEN ELIZABETH NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 BALLSTON AVE, BALLSTON SPA, NY 12020-3606
(518) 884-7150
Mailing address
1154 RIVER RD, TROY, NY 12182-1229
(603) 400-0672
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
893887-01
NY
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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