Nickell, George Robert

Nickell, George Robert is an individual health care provider with primary practice located at Highway 264, Mp 388 , Polacca AZ 86042. He recently has only one registered license in Nursing Service Providers / Emergency, which is considered as his primary health care specialty. Nickell, George Robert can be contacted via phone (928) 737-6000.

Contact Information

Primary practice address
Highway 264, Mp 388 Polacca AZ 86042
Phone: (928) 737-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 1072630 Kentucky

Profile Details

NPI number 1578073441
LBN Legal business name Nickell, George Robert
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2017
Last updated Oct 5th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578073441 NPPES
Arizona MEDICAID 020529

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