Individual
MRS. KATHRYN ANNE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
713 CONNOLLY DR, RED LION, PA 17356-9427
(851) 851-6040
Mailing address
713 CONNOLLY DR, RED LION, PA 17356-9427
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD428322
PA
207RN0300X
Nephrology Physician
Primary
MD428322
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101606926
—
PA
01
—
102479
GEISINGER HEALTH PLAN
PA
01
—
1873066
HIGHMARK BLUE SHIELD
PA
01
—
203272
JOHNS HOPKINS
PA
01
—
2733014000
AMERIHEALTH 65(PA)
PA
01
—
50059837
CAPITAL BC-WMG AHIM
PA
01
—
7252574
AETNA
PA
01
—
883811
CAREFIRST MD BCBS
MD
Enumeration date
09/30/2005
Last updated
12/17/2008
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