Individual
KELLY NICOLE NICKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 843-5851
Mailing address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 843-5851
(321) 843-1673
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
129422
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11007463
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/02/2020
Last updated
01/17/2023
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