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Individual

MS. KAREN GAIL NICKELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN, LMT

Contact information

Practice address
29408 S 548 RD, COOKSON, OK 74427-2423
(918) 630-2342
Mailing address
29408 S 548 RD, COOKSON, OK 74427-2423
(918) 630-2342

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
70432
OK
225700000X
Massage Therapist
Primary
102510
OK

Other

Enumeration date
08/28/2020
Last updated
08/28/2020
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