Kimberly K Nichols, CRNP PHD

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-029355 Issued in AL

Practice address

2431 W Main St Ste 1001
Dothan, AL 36301-6404

Phone

(334) 677-6220

Fax

(334) 677-2206

NPI assigned

Jan 23, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1295547511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GLENDEVON LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363056933",
            "telephone_number": "334-500-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST STE 1001",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363016404",
            "telephone_number": "334-677-6220",
            "fax_number": "334-677-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "CRNP PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-029355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quoc Nguyen
• Marcey Nicholas, CRNP
• Christopher E Nicholls, MD
• Eugene W Nicholls, O.D.
• Melanie P. Nicholls, MD
• Randall Wayne Nichols, M.D.
• Nicole N Thorson, LLC
• Venkat R Nimmagadda, M.D.
• Hannah Harris Nix
• Angie G. Nixon, MA, ALC

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.