Individual
BRENDA JOYCE NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-0488
(214) 648-7150
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-0488
(214) 648-7150
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
PA02265
TX
363A00000X
Physician Assistant
Primary
PA02265
TX
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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