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Individual

KEVIN NICKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
206 CEDAR LN, KNOXVILLE, TN 37912-3507
(865) 666-3640
(865) 666-3641
Mailing address
5201 WESTERN AVE APT 515, KNOXVILLE, TN 37921-4195
(865) 232-8017

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
32232
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32232
TN DEPARTMENT OF HEALTH
TN
Enumeration date
10/04/2022
Last updated
10/04/2022
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