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NPI Code Detail

MEDICARE: CHRISTINE DAWN NICKS

MEDICARE: CHRISTINE DAWN NICKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRXN.0109348-NPCO

General Provider Information

NPI Number : 1518782770
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DAWN NICKS
Provider Business Mailing Address
First Line : 6345 MOCCASIN PASS CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-4452
Country : US
Telephone Number : 719-694-6483
Fax Number :
Provider Business Practice Location Address
First Line : 6345 MOCCASIN PASS CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-4452
Country : US
Telephone Number : 719-694-6483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2024
Last Update Date : 11/21/2024

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Directions to “ CHRISTINE DAWN NICKS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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