Individual
KIM E NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD069962L
PA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
51995
TN
2080P0207X
Pediatric Hematology & Oncology Physician
MD069962L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001780194
—
PA
05
—
8073201
—
NJ
Enumeration date
08/01/2006
Last updated
05/09/2016
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