Individual
MELISSA RENEE NICKOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7120 MINSTREL WAY STE 100, COLUMBIA, MD 21045-5274
(410) 290-6677
Mailing address
7120 MINSTREL WAY STE 100, COLUMBIA, MD 21045-5274
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007235
MD
363A00000X
Physician Assistant
Primary
—
NJ
Other
Enumeration date
06/13/2018
Last updated
03/13/2026
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