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General NPI Number Information
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NPI Number | 1740556471
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Entity Type | Individual
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Provider Name | NICHOLAS GEORGE KAKNES MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1824 9TH ST SE STE C
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City | ROANOKE
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State | VA
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Zip | 24013-2902
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Country | US
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Telephone | 540-595-9332
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Fax | 540-766-5456
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Provider Business Mailing Address
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Address Line | 1824 9TH ST SE STE C
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City | ROANOKE
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State | VA
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Zip | 24013-2902
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Country | US
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Telephone | 540-595-9332
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Fax | 540-766-5456
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME124823
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME124823
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License Number State | FL
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