Healthcare Provider Details

I. General information

NPI: 1417871757
Provider Name (Legal Business Name): KATIA NICHOLAW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 OLIVE HWY STE 270
OROVILLE CA
95966-6135
US

IV. Provider business mailing address

2809 OLIVE HWY STE 270
OROVILLE CA
95966-6135
US

V. Phone/Fax

Practice location:
  • Phone: 530-532-8629
  • Fax:
Mailing address:
  • Phone: 530-532-8629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: