JUDY NICKSICH


Address: 333 Broadway St, Ste. 120, Rock Springs, WY 82901-6243
Phone: 3073626813

JUDY NICKSICH (NPI# 1396167508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396167508
Entity Type Individual
Full Name JUDY NICKSICH
Credential NP
Practice Address 333 Broadway St
Ste. 120
Rock Springs
WY 82901-6243
Practice Telephone 3073626813
Practice Fax Number 3073626791
Mailing Telephone 3073626813
Mailing Fax Number 3073626791
Enumeration Date 2014-01-08
Last Update Date 2016-07-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
8026.0216 WY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 333 BROADWAY ST
STE. 120
City ROCK SPRINGS
State WY
Zip Code 82901-6243

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Taxonomy Information

Taxonomy Code 363LW0102X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Women's Health

Taxonomy Definition

Definition to come...

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Competitor

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City ROCK SPRINGS
Zip Code 82901

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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