Individual provider · Type 1 NPI

Madelyn M. Nickerson, PA-C

Medical Physician Assistant · St. Petersburg, FL

NPI number 1609327816 Active

Practice location

6801 4th St N
St. Petersburg, FL 33702-6844

Call (727) 822-3238 Map

Fax (727) 823-1278

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9109804 (FL)
Physician Assistant 363A00000XPA9109804 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1609327816

Madelyn M. Nickerson, PA-C's National Provider Identifier is 1609327816, issued on Oct 23, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Petersburg, FL. The record was last updated on Apr 12, 2023.