Individual
RANDALL NICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1029 DRY CREEK RD, ELIZABETHTON, TN 37643-5738
(423) 895-8931
Mailing address
1029 DRY CREEK RD, ELIZABETHTON, TN 37643-5738
(423) 895-8931
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
267000
TN
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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