Nickerson, Nancy J

Nickerson, Nancy J is an individual health care provider with primary practice located at 4921 Parkview Pl Div Surg Ct Adult Cardio, Ste 8A, Saint Louis MO 63110-1032. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Nickerson, Nancy J can be contacted via phone (314) 362-7260.

Contact Information

Primary practice address
4921 Parkview Pl Div Surg Ct Adult Cardio, Ste 8A Saint Louis MO 63110-1032
Phone: (314) 362-7260
Fax: (314) 362-6288
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 068264 Missouri

Profile Details

NPI number 1053490508
LBN Legal business name Nickerson, Nancy J
Credentials AHCNS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2006
Last updated Apr 25th, 2024 - about last year

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 1053490508 NPPES
Missouri MEDICAID 420061225

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