| Doctor Name: | LIEM NGUYEN NICKELSON |
| NPI Number: | 1760764138 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.A. |
| License Number: | 2011030647 |
| Business Practice Address: | 3635 Vista Ave Saint Louis, MO - 631102539 |
| Business Phone Number: | 3145778000 |
| Business Fax Number: | |
| Mailing Address: | 544 Lindeman Rd, KIRKWOOD |
| State: | MO |
| Postal Code: | 631223515 |
| Phone Number: | 8134930402 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2011 |
| NPI Last Update Date: | 09/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 367H00000X |
| License Number: | 2011030647 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Anesthesiologist Assistant |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |