HEATHER NICKERSON (Credential# 1229381) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
HEATHER NICKERSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.003135. The credential type is physician assistant. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 308 Killingworth Rd, Higganum, CT 06441. The current status is active.
| Licensee Name | HEATHER NICKERSON |
| Credential ID | 1229381 |
| Credential Number | 23.003135 |
| Credential Type | Physician Assistant |
| Business Address |
308 Killingworth Rd Higganum CT 06441 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2014-07-08 |
| Effective Date | 2020-09-01 |
| Expiration Date | 2021-08-31 |
| Refresh Date | 2020-06-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1233751 | CSP.0058039 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-07-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 308 Killingworth Rd |
| City | Higganum |
| State | CT |
| Zip Code | 06441 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael J. Tanguay | 308 Killingworth Rd, Higganum, CT 06441 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert J Grasso | 44 Thorne Wood Road, Higganum, CT 06441 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Julie A Hajek | 364 Candlewood Hill Road, Higganum, CT 06441 | Dental Hygienist | 2020-05-01 ~ 2021-04-30 |
| Timothy L Brewer | 144 Dublin Hill Rd, Higganum, CT 06441 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michael P Fortuna | 58 Killingworth Road, Higganum, CT 06441 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kelli S Botteon · Brown | 23 Depot Road, Higganum, CT 06441 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| David Wysocki | Po Box 743, Higganum, CT 06441 | Demolition Contractor | 2020-07-01 ~ 2021-06-30 |
| Theresa M Beeman | 28 Teaberry Court, Higganum, CT 06441 | Dental Hygienist | 2020-09-01 ~ 2021-08-31 |
| Ronald Hajek | 364 Candlewood Hill, Higganum, CT 06441 | Sub-surface Sewage Installer | 2020-07-01 ~ 2021-06-30 |
| Heather M Herrington · Ridgeway | 186 Brainard Hill Rd, Higganum, CT 06441 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Brenda L Marinan | P O Box 605, Higganum, CT 06441 | Nursing Home Administrator | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06441 | |||
| City | Higganum |
| Zip Code | 06441 |
| License Type | Physician Assistant |
| License Type + County | Physician Assistant + Higganum |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Heather Bryant | 851 Ne 1st Ave, Miami, FL 33132 | Physician Assistant | 2018-10-30 ~ 2019-04-30 |
| Heather M Rynkowski | 16 Hillwood Dr, Niantic, CT 06357-1823 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Heather A Jolicoeur | 105 Holley Rd, Bristol, CT 06010-5261 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Heather A Bowdre | 40 Prospect Ave, Norwalk, CT 06850-3737 | Physician Assistant | 2010-07-01 ~ 2011-06-30 |
| Crystal A Huynh | 14 Heather Ln, Wilton, CT 06897-4132 | Physician Assistant | 2013-05-22 ~ 2013-11-30 |
| Heather L Storms Pa | 33 Hospital Ave, Danbury, CT 06810 | Physician Assistant | 2004-03-23 ~ 2005-05-31 |
| Heather M Peterson | 31 Delmor Ave, Wilbraham, MA 01095-1554 | Physician Assistant | 2013-10-04 ~ 2014-07-31 |
| Heather A Shackett | 185 Pine St #617, Manchester, CT 06040 | Physician Assistant | 1994-03-14 ~ 1995-03-31 |
| Heather M Tomchik | 12 Quail Run Dr, Danbury, CT 06811-5128 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Heather A Hooper | 729 Quinnipiac Ave, New Haven, CT 06513 | Physician Assistant | 1996-01-29 ~ 1997-02-28 |
Please comment or provide details below to improve the information on HEATHER NICKERSON.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).