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Individual
TYSON B NICKELS
Active
Individual
TYSON B NICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024187654
VA
363L00000X
Nurse Practitioner
34307
TN
363LF0000X
Family Nurse Practitioner
0024187654
VA
363LF0000X
Family Nurse Practitioner
Primary
34307
TN
Other
Enumeration date
07/21/2023
Last updated
04/22/2026
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