Healthcare Provider Details

I. General information

NPI: 1861453946
Provider Name (Legal Business Name): MARGARET B NICKELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD SUITE 720
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

4320 WORNALL RD SUITE 720
KANSAS CITY MO
64111-5941
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-2111
  • Fax: 816-531-6025
Mailing address:
  • Phone: 816-531-2111
  • Fax: 816-531-6025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR8A49
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: