Nickerson, Debra Anne

Nickerson, Debra Anne is an individual health care provider with primary practice located at 1001 Blythe Blvd Suite 200, Charlotte NC 28203-5866. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, which is considered as her primary health care specialty. Nickerson, Debra Anne can be contacted via phone (704) 381-8840.

Contact Information

Primary practice address
1001 Blythe Blvd Suite 200 Charlotte NC 28203-5866
Phone: (704) 381-8840
Fax: (704) 381-8848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X 185859 North Carolina

Profile Details

NPI number 1326274713
LBN Legal business name Nickerson, Debra Anne
Credentials NNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2009
Last updated Nov 28th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326274713 NPPES
South Carolina MEDICAID NP3938
South Carolina MEDICAID 1326274713

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