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General NPI Number Information
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NPI Number | 1689713257
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Entity Type | Individual
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Provider Name | CAROL S NICHOLS NP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 808 PROFESSIONAL BLVD
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City | DALTON
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State | GA
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Zip | 30720
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Country | US
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Telephone | 706-226-2621
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Fax | 706-281-2325
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Provider Business Mailing Address
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Address Line | 5496 GEORGETOWN TRACE
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City | LILBURN
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State | GA
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Zip | 30047
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Country | US
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Telephone | 770-921-5039
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Fax |
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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 | RN029126
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | RN029126
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License Number State | GA
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