Individual
ASTORIA NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 TRUESDELL CT, KEY WEST, FL 33040-0703
(321) 888-4564
Mailing address
PO BOX 703, KEY WEST, FL 33041-0703
(321) 888-4564
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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