Individual
RICHARD LEE NIKKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2282 E PINETREE BLVD, THOMASVILLE, GA 31792-4807
(229) 228-4988
(229) 226-5859
Mailing address
116 HARROGATE LN, THOMASVILLE, GA 31792-8727
(229) 227-1928
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN072148
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430062644
RAILROAD MEDICARE
GA
Enumeration date
07/07/2006
Last updated
04/25/2008
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