Provider Demographics
NPI:1689089013
Name:NICHOLS, HOLLY LYNN (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LYNN
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:LYNN
Other - Last Name:KOKINDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN ROAD, BOX 3808
Mailing Address - Street 2:DUKE UNIVERSITY HOSPITAL-DEPARTMENT OF RADIOLOGY
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-684-7419
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN ROAD, DUKE UNIVERSITY HOSPITAL NORTH
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-684-7419
Practice Address - Fax:864-560-7343
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1448872085R0202X
NC2019-004602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology