Doctor Name: | MRS. NANCY JEAN NICKERSON |
NPI Number: | 1053490508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 068264 |
Business Practice Address: | 3009 N Ballas Rd Suite 360 C St Louis, MO - 63131 |
Business Phone Number: | 3149965287 |
Business Fax Number: | 3144326068 |
Mailing Address: | 113 Staehle Ct, ST LOUIS |
State: | MO |
Postal Code: | 63129 |
Phone Number: | 3148466211 |
Fax Number: | 3144326068 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364S00000X |
License Number: | 068264 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |