Individual
JOE NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 SW ARCHER RD, GAINESVILLE, FL 32608-1134
(352) 265-0111
Mailing address
3915 NW 7TH PL, GAINESVILLE, FL 32607-4811
(352) 538-5862
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9463797
FL
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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