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General NPI Number Information
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NPI Number | 1780650036
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Entity Type | Individual
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Provider Name | HOLLY N NICHOLS NP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 4045 E BELL RD STE 125
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City | PHOENIX
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State | AZ
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Zip | 85032-2238
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Country | US
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Telephone | 602-971-0268
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Fax | 602-971-1556
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Provider Business Mailing Address
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Address Line | 4045 E BELL RD STE 125
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City | PHOENIX
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State | AZ
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Zip | 85032-2238
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Country | US
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Telephone | 602-971-0268
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Fax | 602-971-1556
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22657
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 45627
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 45627
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP7482
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License Number State | AZ
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