Nicklas, Madeline

Nicklas, Madeline is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Nicklas, Madeline can be contacted via phone (228) 863-1132.

Contact Information

Primary practice address
1600 Broad Ave Gulfport MS 39501-3603
Phone: (228) 863-1132
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1316555329
LBN Legal business name Nicklas, Madeline
Credentials CPSS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2020
Last updated Jul 15th, 2020 - about 6 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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