Individual
MRS. EBONY BROOKE NICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6834 COLEMANS CROSSING AVE STE E, HAYES, VA 23072-3337
(804) 677-0223
(804) 210-1550
Mailing address
1619 WINTHROPE DR, NEWPORT NEWS, VA 23602-9638
(804) 677-0223
(804) 210-1550
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HCO-0001769
VA
385H00000X
Respite Care
HCO-0001769
VA
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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