Individual
MS. CHRISTINE NICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 8TH ST, LAFAYETTE, LA 70501-7163
(985) 397-0290
Mailing address
216 8TH ST, LAFAYETTE, LA 70501-7163
(853) 970-2909
(225) 831-9664
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1171824
—
LA
Enumeration date
03/18/2022
Last updated
03/22/2022
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