Provider Demographics
NPI:1598545816
Name:NICHOLAS, KATHERINE HUEY (CPNP-PC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HUEY
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 SUNRAY WAY APT 102
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-8341
Mailing Address - Country:US
Mailing Address - Phone:678-699-4664
Mailing Address - Fax:
Practice Address - Street 1:2145 COUNTRY CLUB RD STE 500
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-2404
Practice Address - Country:US
Practice Address - Phone:910-939-2244
Practice Address - Fax:910-939-2247
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHUEY-G1RP3363LP0200X
NC5018939363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics