Active NPI
Kathryn Denise Nicholson, FNP
- Family Nurse Practitioner
- Marion, IN
National Provider Identifier
1639281132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000936A
- Practice address
- 1700 E 38TH St
Marion, IN 46953-4568 - Phone
- (765) 674-3321
- Fax
- (765) 677-5167
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000936A | IN | Primary |
Addresses
Primary practice location
1700 E 38TH St
Marion, IN 46953-4568
Mailing address
1700 S. 38TH St.
Marion, IN 46953-1465
Phone (765) 674-3321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000936A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369353600000",
"number": "1639281132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 S. 38TH ST.",
"city": "MARION",
"state": "IN",
"postal_code": "469531465",
"telephone_number": "765-674-3321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 38TH ST",
"city": "MARION",
"state": "IN",
"postal_code": "469534568",
"telephone_number": "765-674-3321",
"fax_number": "765-677-5167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "KATHRYN",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2013-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000936A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.