Individual
VICKIE LYNN NICKELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TRADITIONAL MIDWIFE
Contact information
Practice address
224 SCHOONER BAY DR, BROOKINGS, OR 97415-9061
(541) 661-4652
Mailing address
224 SCHOONER BAY DR, BROOKINGS, OR 97415-9061
(541) 661-4652
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022-0025
OREGON HEALTH AUTHORITY MIDWIFE NUMBER
OR
Enumeration date
08/04/2022
Last updated
08/04/2022
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