Individual
MR. NICKOLAS LEE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
392 ROCHESTER CROSSING DR, ROCHESTER, IN 46975-7034
(574) 325-5912
Mailing address
392 ROCHESTER CROSSING DR, ROCHESTER, IN 46975-7034
(574) 325-5912
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7101337A
IN
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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