Individual
NICKEY NOID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1709 CEDAR DR, BRYANT, AR 72019-6378
(501) 838-8934
Mailing address
1709 CEDAR DR, BRYANT, AR 72019-6378
(501) 838-8934
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A006262
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A006262
—
AR
Enumeration date
05/26/2019
Last updated
05/26/2019
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