Individual
SAMANTHA EVANGELINE NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 S CUSHMAN ST, FAIRBANKS, AK 99701-7516
(907) 452-1648
(907) 456-4849
Mailing address
3100 S CUSHMAN ST, FAIRBANKS, AK 99701-7516
(907) 452-1648
(907) 456-4849
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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