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General NPI Number Information
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NPI Number | 1982233227
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Entity Type | Individual
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Provider Name | KAYLA ANNE NICHOLS PHARMD, BCCCP
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 904-392-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 361 17TH ST NW UNIT 2013
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City | ATLANTA
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State | GA
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Zip | 30363-1090
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Country | US
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Telephone | 904-392-9588
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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 | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | RPH029229
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License Number State | GA
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