National Provider Identifier
Kellyrose Mary Nichols, D.O.
Kellyrose Mary Nichols, D.O. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Le Roy, NY and a listed phone number of (585) 768-2620.
Profile Overview
- NPI
- 1013274638
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- April 20, 2012
- Last Updated
- June 28, 2023
Practice Location
- 8745 Lake Street RD
- Le Roy, NY 14482-9344
Phone: (585) 768-2620
Specialties
- Family Medicine Physician (207Q00000X)
Endpoints
- knichols102610@direct.urmc.rochester.edu
Direct Messaging Address | Direct | Other | Rochester, NY 14642
Full Record
- NPI
- 1013274638
- Entity Type
- Individual
- Last Name
- Nichols
- First Name
- Kellyrose
- Middle Name
- Mary
- Name Prefix
- Dr.
- Credential
- D.O.
- Mailing Street Address
- 8745 Lake Street RD
- Mailing City
- Le Roy
- Mailing State
- NY
- Mailing ZIP Code
- 14482-9344
- Mailing Country
- US
- Mailing Phone
- (585) 768-2620
- Practice Street Address
- 8745 Lake Street RD
- Practice City
- Le Roy
- Practice State
- NY
- Practice ZIP Code
- 14482-9344
- Practice Country
- US
- Practice Phone
- (585) 768-2620
- Enumeration Date
- April 20, 2012
- Last Updated
- June 28, 2023
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)