Individual
HOLLY N NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4045 E BELL RD STE 125, PHOENIX, AZ 85032-2238
(602) 971-0268
(602) 971-1556
Mailing address
4045 E BELL RD STE 125, PHOENIX, AZ 85032-2238
(602) 971-0268
(602) 971-1556
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
45627
KS
363L00000X
Nurse Practitioner
22657
CA
363L00000X
Nurse Practitioner
45627
KS
363L00000X
Nurse Practitioner
Primary
AP7482
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011884
—
AZ
05
—
200266080A
—
KS
Enumeration date
02/27/2006
Last updated
02/04/2025
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