MRS. LILLIAN MISHELLE NICKS (NPI# 1558641670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558641670 |
| Entity Type | Individual |
| Full Name | MRS. LILLIAN MISHELLE NICKS |
| Credential | FNP |
| Practice Address |
104 Innovation Dr Suite 2000 Greenville SC 29607-5253 |
| Mailing Address |
Po Box 743294 Atlanta GA 30374-3294 |
| Practice Telephone | 8646036300 |
| Practice Fax Number | 8646036160 |
| Mailing Telephone | 8646036300 |
| Mailing Fax Number | 8646036160 |
| Enumeration Date | 2011-08-20 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
17527 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP2272 | 05 |
| Street Address |
104 INNOVATION DR SUITE 2000 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29607-5253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518901545 | Robert D Siegel | Internal Medicine | 104 Innovation Dr, Ste. 2000, Greenville, SC 29607-5253 | 2006-06-16 |
| 1770049009 | Sarah Burre Loudermilk | Nurse Practitioner | 104 Innovation Dr, Greenville, SC 29607-5253 | 2019-02-12 |
| 1366927204 | Kate Mcclellan | Nurse Practitioner | 104 Innovation Dr, Greenville, SC 29607-5253 | 2018-09-26 |
| 1740686591 | St. Francis Hospital Inc | Radiology | 104 Innovation Dr, Greenville, SC 29607-5253 | 2014-11-06 |
| 1023418035 | St. Francis Hospital Inc | General Acute Care Hospital | 104 Innovation Dr, Greenville, SC 29607-5253 | 2014-08-27 |
| 1982927992 | St Francis Physician Services Inc | Internal Medicine | 104 Innovation Dr, Suite 2000, Greenville, SC 29607-5253 | 2010-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846138 | Personalized Home Care Services | Technician | 1200 Woodruff Rd A3 Ste 150, Greenville, SC 29607 | 2020-09-16 |
| 1396361960 | Complete Homecare of America, Inc. | In Home Supportive Care | 128 Millport Circle, Suite 200, Greenville, SC 29607 | 2020-06-19 |
| 1275175093 | Carrie Laxton Ballenger | Nurse Practitioner | 2094 Woodruff Road, Greenville, SC 29607 | 2019-10-14 |
| 1861047037 | Susannah Long | Marriage & Family Therapist | 109 Laurens Road, Building 4 Ste D, Greenville, SC 29607 | 2019-08-05 |
| 1043872369 | Cheryl Craig Rosemond | Case Manager/Care Coordinator | 5 Century Drive, Suite 130, Greenville, SC 29607 | 2019-07-08 |
| 1457916561 | After Hours Chiropractic LLC | Chiropractor | 1200 Woodruff Rd Blg A-3, Simpsonville, SC 29607 | 2019-05-03 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1124502307 | Martha Irby | Home Health Aide | 2320 E North St Rr 107, Greenville, SC 29607 | 2018-09-24 |
| 1780164541 | Suval Psychiatric Services, Pa | Clinic/Center | 33 Market Point Dr Ste 2023, Greenville, SC 29607 | 2018-08-20 |
| 1083113963 | Caroline Graham | Nurse Practitioner | 850 S Pleasantburg Dr, Greenville, SC 29607 | 2018-02-06 |
| Find all providers in zip 29607 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
| 1700403276 | Carolyn Lisa Fry | Nurse Practitioner | 500 Baylor Dr Apt Suite, Greenville, TX 75402-8005 | 2020-07-01 |
| 1033744701 | Jennifer C Carpenter | Nurse Practitioner | 2018 County Road 3318, Greenville, TX 75402-5268 | 2020-03-03 |
| 1659904183 | Joante Kirk | Nurse Practitioner | 1699 S Main St, Greenville, MS 38701-7364 | 2020-02-12 |
| 1578103859 | Michelle Earley | Nurse Practitioner | 4221 Ridgecrest Rd Ste 107, Greenville, TX 75402-6015 | 2020-01-14 |
| 1871138149 | Paola Andrea Mora Tobon | Nurse Practitioner | 200 Patewood Dr Ste 320, Greenville, SC 29615-3593 | 2019-11-11 |
| 1144863895 | Rashemia Latricia Suber | Nurse Practitioner | 814 Riviera Cir N, Greenville, MS 38701-8029 | 2019-10-25 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1487116745 | Megan Rogers Semanski | Nurse Practitioner | 890 W Faris Rd Ste 510, Greenville, SC 29605-4286 | 2019-04-04 |
| 1053884247 | Renee L Bridges | Nurse Practitioner | 10 Enterprise Blvd Ste 202, Greenville, SC 29615-3554 | 2019-01-10 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29607 |
Please comment or provide details below to improve the information on MRS. LILLIAN MISHELLE NICKS.
| 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.