Provider Demographics
NPI:1285104513
Name:NICKELS, CHRISTY (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:NICKELS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0620
Mailing Address - Country:US
Mailing Address - Phone:308-568-8577
Mailing Address - Fax:308-568-3611
Practice Address - Street 1:611 W FRANCIS ST STE 150
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-0614
Practice Address - Country:US
Practice Address - Phone:308-568-8577
Practice Address - Fax:308-568-3611
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2081363LF0000X
NE112675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily