Individual
MRS. DANA LYNNETTE NICKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
252 WHITTINGTON PKWY, LOUISVILLE, KY 40222-4904
(502) 423-7246
(502) 426-7247
Mailing address
PO BOX 26798, BELFAST, ME 04915-2018
(888) 488-8289
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3005528
KY
363LF0000X
Family Nurse Practitioner
71002399A
IN
363LG0600X
Gerontology Nurse Practitioner
3005528
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000635581
ANTHEM
IN
05
—
200955730
—
IN
Enumeration date
05/29/2007
Last updated
10/06/2023
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