Nichols, Kelly K.
Nichols, Kelly K. is an individual health care provider with primary practice located at 1716 University Blvd Hpb G080A, Birmingham AL 35294-0010. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Nichols, Kelly K. can be contacted via phone (205) 975-2020.Contact Information
Primary practice address
1716 University Blvd Hpb G080A
Birmingham AL 35294-0010
Phone: (205) 975-2020
Fax: (205) 934-6755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T-215-TA-976 | Alabama |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 4722/T1517 | Ohio |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 7914TG | Texas |
| Eye and Vision Services Providers / Optometrist | 152W00000X | R-222-TA-976 | Alabama |
Profile Details
| NPI number | 1558327817 |
|---|---|
| LBN Legal business name | Nichols, Kelly K. |
| Credentials | OD, MPH, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Jul 24th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558327817 | NPPES |
| Texas | MEDICAID | 112409104 |
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