National Provider Identifier
Kelly Theresa Nichols
Kelly Theresa Nichols is listed in the NPPES registry with a primary specialty of Pediatric Registered Nurse in North Tonawanda, NY and a listed phone number of (716) 472-5649.
Profile Overview
- NPI
- 1710613120
- Provider Type
- Individual
- Primary Specialty
- Pediatric Registered Nurse
- Enumeration Date
- July 27, 2022
- Last Updated
- July 27, 2022
Practice Location
- 526 Euclid Ave
- North Tonawanda, NY 14120-4205
Phone: (716) 472-5649
Specialties
- Pediatric Registered Nurse (163WP0200X)
Full Record
- NPI
- 1710613120
- Entity Type
- Individual
- Last Name
- Nichols
- First Name
- Kelly
- Middle Name
- Theresa
- Mailing Street Address
- 526 Euclid Ave
- Mailing City
- North Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14120-4205
- Mailing Country
- US
- Mailing Phone
- (716) 472-5649
- Practice Street Address
- 526 Euclid Ave
- Practice City
- North Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14120-4205
- Practice Country
- US
- Practice Phone
- (716) 472-5649
- Enumeration Date
- July 27, 2022
- Last Updated
- July 27, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- July 27, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Registered Nurse (163WP0200X)