Individual
JACQUELYN MARIE NICKELE
Active
Individual
JACQUELYN MARIE NICKELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9476
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
12012676A
IN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9476
KY
Other
Enumeration date
04/28/2014
Last updated
05/31/2017
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