Nickerson, Chevonne Marie

Nickerson, Chevonne Marie is an individual health care provider with primary practice located at 130 Centerway , Corning NY 14830. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Nickerson, Chevonne Marie can be contacted via phone (607) 973-8000.

Contact Information

Primary practice address
130 Centerway Corning NY 14830
Phone: (607) 973-8000
Fax: (607) 973-8161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X F331493 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F331493-1 New York

Profile Details

NPI number 1386616977
LBN Legal business name Nickerson, Chevonne Marie
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Mar 24th, 2021 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1386616977 NPPES
New York Other 500019277 RR MEDICARE PIN
New York MEDICAID 01731906 RR MEDICARE PIN
New York Other CC8362 RR MEDICARE PIN

Popular Providers