Nickerson, Renee

Nickerson, Renee is an individual health care provider with primary practice located at 4567 Crossroads Park Dr , Liverpool NY 13088-3589. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Nickerson, Renee can be contacted via phone (315) 883-1631.

Contact Information

Primary practice address
4567 Crossroads Park Dr Liverpool NY 13088-3589
Phone: (315) 883-1631
Fax: (315) 883-1688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 402840 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 335994 New York

Profile Details

NPI number 1760797229
LBN Legal business name Nickerson, Renee
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2010
Last updated Dec 29th, 2020 - about 4 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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