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Individual

MR. SCOTT LEE NICKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, FNP

Contact information

Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3621
(510) 450-5693
Mailing address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3621
(510) 450-5693

Taxonomy

Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
551822
CA
363LF0000X
Family Nurse Practitioner
13117
CA
363LX0106X
Occupational Health Nurse Practitioner
Primary
NP13117
CA

Other

Enumeration date
10/28/2008
Last updated
05/28/2026
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