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General NPI Number Information
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NPI Number | 1801883327
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Entity Type | Individual
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Provider Name | KATHRYN ANNE NICHOLSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 713 CONNOLLY DR
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City | RED LION
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State | PA
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Zip | 17356-9427
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Country | US
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Telephone | 851-851-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 713 CONNOLLY DR
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City | RED LION
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State | PA
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Zip | 17356-9427
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Country | US
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Telephone |
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD428322
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License Number State | PA
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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 | MD428322
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License Number State | PA
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