Individual
NICOLLE KIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4500 8TH DIVISION RD, COLUMBIA, SC 29207-5700
(803) 751-2273
Mailing address
4500 8TH DIVISION RD, COLUMBIA, SC 29207-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1198872
KS
Other
Enumeration date
07/28/2022
Last updated
08/13/2025
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