Individual
NICOLE LYNNE NICKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP CCC
Contact information
Practice address
2258 N LAKEWAY CIR, WICHITA, KS 67205-1082
(316) 945-7117
(316) 945-7447
Mailing address
3223 N OLIVER ST, WICHITA, KS 67220-2106
(316) 267-5437
(316) 267-5444
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4049
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679671671
—
KS
Enumeration date
01/30/2017
Last updated
01/30/2017
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