Individual
ALEXA ANN NICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, WHNP-BC
Contact information
Practice address
11123 PARKVIEW PLAZA DR STE 101, FORT WAYNE, IN 46845-1707
(260) 425-6650
(260) 425-6649
Mailing address
207 N ELKHART ST, WAKARUSA, IN 46573-9729
(574) 390-0241
(574) 393-9943
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
09000490A
IN
363LW0102X
Women's Health Nurse Practitioner
104216827
IN
364SW0102X
Women's Health Clinical Nurse Specialist
28276535A
IN
367A00000X
Advanced Practice Midwife
Primary
09000490A
IN
Other
Enumeration date
02/24/2025
Last updated
03/11/2026
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