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General NPI Number Information
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NPI Number | 1336594928
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Entity Type | Individual
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Provider Name | LORETTA KAY NICHOLS APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 6500 HIGHWAY 645 STE 110
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City | INEZ
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State | KY
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Zip | 41224
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Country | US
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Telephone | 606-298-3412
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 KY ROUTE 321 SUITTE 3
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9097
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Country | US
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Telephone | 606-886-8546
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Fax | 606-886-8548
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3010245
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License Number State | KY
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