Nickerson, Michael

Nickerson, Michael is an individual health care provider with primary practice located at 333 Borthwick Ave Emergency Department, Portsmouth NH 03801-7128. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Nickerson, Michael can be contacted via phone (603) 433-4012.

Contact Information

Primary practice address
333 Borthwick Ave Emergency Department Portsmouth NH 03801-7128
Phone: (603) 433-4012
Fax: (603) 433-5184
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 033993-23-03 New Hampshire

Profile Details

NPI number 1942219381
LBN Legal business name Nickerson, Michael
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Aug 10th, 2012 - about 12 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 1942219381 NPPES
Massachusetts MEDICAID 0711608
Massachusetts Other 930112668
Massachusetts MEDICAID 247490099
Massachusetts MEDICAID 30011603
Massachusetts Other 4007290Y0NH01

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