Provider Demographics
NPI:1992338297
Name:NICHOLSON, DAVID P (APRN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1827
Mailing Address - Country:US
Mailing Address - Phone:859-288-2425
Mailing Address - Fax:859-721-2572
Practice Address - Street 1:496 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1827
Practice Address - Country:US
Practice Address - Phone:859-288-2425
Practice Address - Fax:859-721-2572
Is Sole Proprietor?:No
Enumeration Date:2020-02-15
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014357363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health