Individual
MR. NICKLOS MICHAEL MARKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
67 GLENWOOD RD, SOUTH WINDSOR, CT 06074-3027
(860) 648-2620
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
003546
CT
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
003546
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003546
CT APRN LICENSE
CT
Enumeration date
03/20/2008
Last updated
02/19/2011
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