Individual
CHRISTINA MARIE NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3243 E MURDOCK ST, SUITE 404, WICHITA, KS 67208-3052
(316) 268-5000
Mailing address
3243 E MURDOCK ST, SUITE 404, WICHITA, KS 67208-3052
(316) 685-6222
(316) 685-1273
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
6352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016633002
MEDICARE
KS
05
—
200663440A
—
KS
Enumeration date
05/01/2007
Last updated
09/09/2021
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