Individual
CHERYL MARIE NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
G.N.P.
Contact information
Practice address
7009 RUMSEY RD EXTENSION, BATH, NY 14810
(607) 661-9114
(607) 664-1020
Mailing address
150 PRATTSBURG RD., NAPLES, NY 14512
(585) 943-1538
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
340488
NY
363LG0600X
Gerontology Nurse Practitioner
F340488-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02829629
—
NY
Enumeration date
10/23/2006
Last updated
04/27/2019
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