CAROL CRISTMAN NICKLESS


Address: 12366 Grandee Ct, San Diego, CA 92128-2120
Phone: 8586760096

CAROL CRISTMAN NICKLESS (NPI# 1427171008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427171008
Entity Type Individual
Full Name CAROL CRISTMAN NICKLESS
Credential RN, PHN, BSN
Practice Address 12366 Grandee Ct
San Diego
CA 92128-2120
Practice Telephone 8586760096
Mailing Telephone 8586760096
Enumeration Date 2007-04-09
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WC1500X Registered Nurse
Specialization: Community Health
536023 CA Nursing Service Providers

Office Location

Street Address 12366 GRANDEE CT
City SAN DIEGO
State CA
Zip Code 92128-2120

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1336659218 Ryan Fong Physician Assistant 15004 Innovation Drive (s97), San Diego, CA 92128 2017-10-05
1508316191 Araceli Flores Behavioral Analyst 15737 Innovation Dr, Suite 200, San Diego, CA 92128 2016-10-07
1003283961 Katherine Dishner Hearing Instrument Specialist 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 2015-08-27
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1346623634 Angela Christine Storck-petersen Dietitian, Registered 11768 Caminito Corriente, San Diego, CA 92128 2015-07-04
1134526874 Breeana Rose Lancaster Speech-Language Pathologist 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 2014-11-24
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Taxonomy Information

Taxonomy Code 163WC1500X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Community Health

Taxonomy Definition

Definition to come...

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1760043855 Evan Christian Ramirez Registered Nurse 5560 Overland Ave Ste 310, San Diego, CA 92123-1204 2019-06-28
1093376782 Richard Chen Registered Nurse 2764 Escala Cir, San Diego, CA 92108-6726 2019-06-24
1962982298 Marsue A Evans Registered Nurse 5931 Gullstrand St, San Diego, CA 92122-3819 2018-08-16
1982123360 Huyen Dao Registered Nurse 5560 Overland Ave Ste 202, San Diego, CA 92123-1204 2017-09-17
1053845404 Diana Vaughan-jones Registered Nurse 3158 Clairemont Dr, San Diego, CA 92117-6411 2017-04-12
1083911226 Xochitl Artemiza Stockton Registered Nurse 4377 39th St, Apt 4, San Diego, CA 92105-1036 2011-02-24
1801916226 Maria Theresa Abe Llamado Registered Nurse 2022 Howard Ave, San Diego, CA 92104-1016 2007-03-30
1356461172 Linda Marie France Registered Nurse 1255 Imperial Ave, San Diego, CA 92101-7493 2007-03-29
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Competitor

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City SAN DIEGO
Zip Code 92128

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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