Nickey, Kimberly Joy

Nickey, Kimberly Joy is an individual health care provider with primary practice located at 162 N Country Rd , Port Jefferson NY 11777-2120. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Nickey, Kimberly Joy can be contacted via phone (631) 828-8013.

Contact Information

Primary practice address
162 N Country Rd Port Jefferson NY 11777-2120
Phone: (631) 828-8013
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 634894-1 New York

Profile Details

NPI number 1063716736
LBN Legal business name Nickey, Kimberly Joy
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2011
Last updated Jan 10th, 2011 - about 14 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 1063716736 NPPES
New York MEDICAID 634894-1

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