Kerrich Nicholson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00055779 Issued in WA

Practice address

836 S Rochester St
Tacoma, WA 98465-1836

Phone

(253) 301-7887

NPI assigned

Mar 20, 2019

Sex

Male

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

State licenses

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1528528247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 S ROCHESTER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651836",
            "telephone_number": "253-301-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 S ROCHESTER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651836",
            "telephone_number": "253-301-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KERRICH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00055779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Maria Nichols, PTA
• Nicole Elaine Nichols, MA00006680
• Sarah Grace Nichols, RN, MSN, CCM
• Stefani Doreen Nichols, RN
• Gary Warner Nicholson, ATC
• Lisa M Nicholson, M.D.
• Patrick Henry Nicholson Jr.
• Sage Minnette Nicholson
• Adam Todd Nickel, DO
• Gary Wayne Nickel, M.D.

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.