Nickens, Angela M

Nickens, Angela M is an individual health care provider with primary practice located at 4025 Health Park Ln , Saint Joseph MI 49085-3421. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Nickens, Angela M can be contacted via phone (269) 429-7100.

Contact Information

Primary practice address
4025 Health Park Ln Saint Joseph MI 49085-3421
Phone: (269) 429-7100
Fax: (269) 429-1959
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704221750 Michigan

Profile Details

NPI number 1326401639
LBN Legal business name Nickens, Angela M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2016
Last updated May 23rd, 2016 - about 9 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 1326401639 NPPES
Michigan Other 4704221750 LICENSE
Michigan MEDICAID 1326401639 LICENSE

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