ALICIA FAULK NICKLAS (NPI# 1487188256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487188256 |
| Entity Type | Individual |
| Full Name | ALICIA FAULK NICKLAS |
| Credential | NP |
| Practice Address |
104 Genevieve Dr Lafayette LA 70503-4811 |
| Practice Telephone | 3379840110 |
| Practice Fax Number | 3379817210 |
| Mailing Telephone | 3379840110 |
| Mailing Fax Number | 3379817210 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2018-09-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP09172 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
104 GENEVIEVE DR |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70503-4811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346251865 | Powlin Viswas Manuel | Allergy & Immunology | 104 Genevieve Dr, Lafayette, LA 70503-4811 | 2006-08-10 |
| 1619145786 | Jaime Suhrhoff Woodring | Nurse Practitioner | 104 Genevieve Dr, Lafayette, LA 70503-4811 | 2008-02-12 |
| 1679620603 | Manuel Medical Clinic, Inc. | Allergy & Immunology | 104 Genevieve Dr, Lafayette, LA 70503-4811 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962024620 | The Carpenter Center for Palliative Medicine of Lafayette, LLC | General Acute Care Hospital | 923 West Pinhook Road, Lafayette, LA 70503 | 2020-05-15 |
| 1326679143 | Elisabeth Robertson | Speech-Language Pathologist | 227b Bendel Rd., Ste. C, Lafayette, LA 70503 | 2020-01-30 |
| 1497391973 | Solvet Services LLC | Durable Medical Equipment & Medical Supplies | 345 Doucet Rd., Suite 212, Lafayette, LA 70503 | 2019-11-20 |
| 1023654712 | Louisiana Cardiac Vascular and Pulmonary Rehab LLC | Registered Nurse | 2701 Johnston Street, Ste 100, Lafayette, LA 70503 | 2019-11-18 |
| 1972147346 | Ryan Christopher Winters | Counselor | 143 Ridgeway Dr., Lafayette, LA 70503 | 2019-10-29 |
| 1861046112 | Lafayette General Medical Center Inc | General Acute Care Hospital | 1213 Coolidge Street, Lafayette, LA 70503 | 2019-07-25 |
| 1770041295 | Karen R Rue | Registered Nurse | 1001 W. Pinhook Rd, Bldg #3, Ste. 212, Lafayette, La, LA 70503 | 2019-03-04 |
| 1235601766 | Frances Chauvin, Dds, LLC | Dentist | 229 Bendel Rd., Lafayette, LA 70503 | 2018-12-21 |
| 1710456116 | Affordable Caregivers, Inc. | In Home Supportive Care | 515 South College Rd., Suite 125, Lafeyette, LA 70503 | 2018-11-15 |
| 1366911778 | Taylor Callais-rusich | Counselor | 142 Ridgeway Dr., 201, Lafayette, LA 70503 | 2018-11-14 |
| Find all providers in zip 70503 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578056842 | Jenna Elizabeth Bednarski | Nurse Practitioner | 3741 Rome Dr Ste B, Lafayette, IN 47905-4490 | 2018-06-12 |
| 1033505912 | Erin Gena Monachello | Nurse Practitioner | 401 Youngsville Hwy Ste 100, Lafayette, LA 70508-5173 | 2015-04-08 |
| 1710319009 | Megan Elizabeth Chapman | Nurse Practitioner | 1716 Hartford Stree, Lafayette, IN 47904-2138 | 2013-08-08 |
| 1932358660 | Claire F. Bailey | Nurse Practitioner | 5000 Ambassador Caffery Pkwy Bldg 12, Lafayette, LA 70508-6984 | 2008-09-18 |
| 1417995242 | Elizabeth A Jones | Nurse Practitioner | 3741 Rome Dr, Ste. B, Lafayette, IN 47905-4490 | 2006-06-03 |
| 1407807134 | Melissa Hope Nice | Nurse Practitioner | 415 N 26th St Ste 201, Lafayette, IN 47904-2856 | 2006-05-15 |
| 1962058743 | Rita M Becker | Nurse Practitioner | 2316 South St, Lafayette, IN 47904-2971 | 2019-08-16 |
| 1013486588 | Rebekah Hurst | Nurse Practitioner | 1716 Hartford St., Lafayette, IN 47904-2138 | 2018-11-14 |
| 1295218071 | Hannah Henderson | Nurse Practitioner | 2316 South St, Lafayette, IN 47904-2971 | 2018-09-08 |
| 1568972446 | Heather F. Champagne | Nurse Practitioner | 401 Youngsville Hwy Ste 100, Lafayette, LA 70508-5173 | 2017-10-05 |
| Find all providers in LAFAYETTE | ||||
Please comment or provide details below to improve the information on ALICIA FAULK NICKLAS.
| 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.