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NPI Code Detail

MEDICARE: DR. JACINDA MAWSON NICKLAS M.D., MPH

MEDICARE: DR. JACINDA MAWSON NICKLAS M.D., MPH
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
1207R00000XInternal Medicine PhysicianDR.0051872CO
2207R00000XInternal Medicine Physician224827MA

General Provider Information

NPI Number : 1063549970
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACINDA MAWSON NICKLAS M.D., MPH
Provider Business Mailing Address
First Line : PO BOX 110429
Second Line :
City : AURORA
State : CO
Zip : 80042-0429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1635 AURORA CT
Second Line :
City : AURORA
State : CO
Zip : 80045-2541
Country : US
Telephone Number : 720-848-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 02/19/2026

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