Individual
MARIE D NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 HOUSTON ST, SUITE A, LEXINGTON, VA 24450-2455
(540) 463-2181
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003512
VA
Other
Enumeration date
01/24/2011
Last updated
08/11/2022
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