Individual
REBECCA J NICKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
206 W COUNTY LINE RD STE 300, HIGHLANDS RANCH, CO 80129
(303) 795-5980
(303) 795-7881
Mailing address
13402 W COAL MINE AVE, STE 230, LITTLETON, CO 80127-5407
(303) 730-2167
(303) 996-4820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43043
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020422
KAISER COMMERCIAL NUMBER
CO
01
—
403385YU8D
GROUP MEMBER PTAN
CO
05
—
9000144571
—
CO
Enumeration date
04/06/2006
Last updated
09/27/2021
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