Individual
STEPHANIE L NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
480 CENTRAL AVE, JBPHH, HI 96860-4908
(808) 473-1880
Mailing address
514 OHANA NUI CIR, HONOLULU, HI 96818-4425
(813) 380-1341
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH2400
HI
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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