Individual
MRS. KAREN MAY NICKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
221 E MAIN ST, PALMYRA, NY 14522-1127
(315) 502-4085
(315) 502-4086
Mailing address
221 E MAIN ST, PALMYRA, NY 14522-1127
(315) 502-4085
(315) 502-4086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
212521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01914272
—
NY
01
—
1142
BLUE CROSS/BLUE SHIELD
NY
01
—
MDE045
PREFERRED CARE
NY
01
—
P010212521
BLUE CHOICE
NY
Enumeration date
03/21/2006
Last updated
03/23/2009
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