Individual
JEREMY DON NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
914 BAUMANN DR, GRAND ISLAND, NE 68803-4401
(308) 385-5250
(308) 385-5271
Mailing address
914 BAUMANN DR, GRAND ISLAND, NE 68803-4401
(308) 385-5250
(308) 385-5271
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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