IndividualActive
Kimberly Nicoll, M.D.
NPI 1679758809 · Multi-Specialty Clinic/Center · Lansdowne, VA
Provider details
- NPI number
- 1679758809
- Entity type
- Individual
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0101249379 (VA)
Practice location
19415 Deerfield Ave Ste 209
Lansdowne, VA 20176-8471
Phone: (571) 375-6712
Mailing address
19415 Deerfield Ave Ste 209
Lansdowne, VA 20176-8471
Registry dates
- Enumerated
- 2008-01-07
- Last updated
- 2025-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.