Individual
NICKOLE HACKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
36996 WALNUT PARK LN, PURCELLVILLE, VA 20132-3499
(304) 616-0645
Mailing address
36996 WALNUT PARK LN, PURCELLVILLE, VA 20132-3499
(304) 616-0645
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
—
CT
227900000X
Registered Respiratory Therapist
—
MA
227900000X
Registered Respiratory Therapist
Primary
—
VA
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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