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Individual
DR. TERESANN NICKLE
Active
Individual
DR. TERESANN NICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC, DN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
501703
CA
363LF0000X
Family Nurse Practitioner
RN501703
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
501703
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71012379A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN501703
CA
Other
Enumeration date
01/25/2007
Last updated
03/16/2022
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