Provider Demographics
NPI:1437316114
Name:NICHOLSON, KATHERINE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1001 JOHNSON FERRY RD NE
Mailing Address - Street 2:SCOTTISH RITE CHILDREN'S HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1605
Mailing Address - Country:US
Mailing Address - Phone:678-344-1960
Mailing Address - Fax:678-344-1960
Practice Address - Street 1:1001 JOHNSON FERRY RD NE
Practice Address - Street 2:SCOTTISH RITE CHILDREN'S HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1605
Practice Address - Country:US
Practice Address - Phone:678-344-1960
Practice Address - Fax:678-344-1960
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2010-06-10
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Provider Licenses
StateLicense IDTaxonomies
390200000X
GA63930207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program