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General NPI Number Information
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NPI Number | 1770437683
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Entity Type | Individual
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Provider Name | ALEXIS NICKLES
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Gender | Female
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 901 W ST NW APT 300
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City | WASHINGTON
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State | DC
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Zip | 20001-5680
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Country | US
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Telephone | 202-599-1832
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 GLADSTONE DR
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City | ROCKVILLE
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State | MD
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Zip | 20851-1054
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Country | US
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Telephone | 540-273-9102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP50013897
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License Number State | DC
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