Individual
AVA T NICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CRNP
Contact information
Practice address
211 EASY ST, UNIONTOWN, PA 15401-3129
(724) 320-0849
Mailing address
211 EASY ST, UNIONTOWN, PA 15401-3129
(724) 320-0849
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
109023
WV
363LF0000X
Family Nurse Practitioner
Primary
SP023775
PA
Other
Enumeration date
04/29/2021
Last updated
04/09/2022
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