Individual provider · Type 1 NPI

Katie Elizabeth Nichols, PA-C

Surgical Physician Assistant · Nampa, ID

NPI number 1700447141 Active

Practice location

4400 E Flamingo Ave Ste 200
Nampa, ID 83687-9203

Fax (208) 367-2725

Mailing address

PO Box 190930
Boise, ID 83719-0930

Other practice locations

  • 1072 N Liberty St Ste 201, Boise, ID 83704 · (208) 302-2400

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Surgical Physician Assistant 363AS0400XPA9112309 (FL)
Surgical Physician Assistant Primary 363AS0400XPA-1889 (ID)

Surgical Physician Assistant: Definition to come...

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About NPI 1700447141

Katie Elizabeth Nichols, PA-C's National Provider Identifier is 1700447141, issued on Jun 26, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Nampa, ID. The record was last updated on Sep 12, 2023.