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Individual

MRS. TIFFANY NICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
381 STATE ROUTE 3117, SOUTH SHORE, KY 41175-9599
(606) 225-3751
Mailing address
381 STATE ROUTE 3117, SOUTH SHORE, KY 41175-9599
(606) 225-3751

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
Primary
374U00000X
Home Health Aide

Other

Enumeration date
06/02/2023
Last updated
06/02/2023
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