Provider Demographics
NPI:1770260010
Name:NICHOLSON, KATHY LEIGH
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LEIGH
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 GREGG ST
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-3303
Mailing Address - Country:US
Mailing Address - Phone:336-847-3552
Mailing Address - Fax:
Practice Address - Street 1:325 GREGG ST
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-3303
Practice Address - Country:US
Practice Address - Phone:336-847-3552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula