Individual provider · Type 1 NPI
Michael Scott Nickerson, MS, ARNP-C, COHN-S
Adult Health Nurse Practitioner · St. Petersburg, FL
NPI number
1649691122
Active
Practice location
700 5th Ave S
St. Petersburg, FL 33785
Mailing address
2625 NE 14th Ave Apt 105
Oakland Park, FL 33334-4395
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 3297762 (FL) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1649691122
Michael Scott Nickerson, MS, ARNP-C, COHN-S's National Provider Identifier is 1649691122, issued on Dec 30, 2013. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in St. Petersburg, FL. The record was last updated on Jan 7, 2015.