DR. JENNIFER A NICKELL (NPI# 1710082433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710082433 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER A NICKELL |
| Other Name | JENNIFER A WALLER |
| Credential | MD |
| Practice Address |
1013 N Main St Sikeston MO 63801-5043 |
| Practice Telephone | 5734727535 |
| Practice Fax Number | 5734727787 |
| Mailing Telephone | 5734727535 |
| Mailing Fax Number | 5734727787 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2018-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2003020141 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 209171404 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164832713 | Jennifer Nickell | Dietitian, Registered | 9307 Sw 51st Ave, Portland, OR 97219-5118 | 2014-05-05 |
| 1326645417 | Jennifer Nickell | Registered Nurse | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3079 | 2020-10-02 |
| 1750932661 | Jennifer Nickell | Counselor | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-09-23 |
| 1538492103 | Jennifer Lynn Nickell | Pharmacist | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2009-09-14 |
| Street Address |
1013 N MAIN ST |
| City | SIKESTON |
| State | MO |
| Zip Code | 63801-5043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437440245 | Fallan Nichole Mayabb | Obstetrics & Gynecology | 1013 N Main St, Sikeston, MO 63801-5043 | 2011-04-27 |
| 1508941626 | Sherry D Welker | Nurse Practitioner | 1013 N Main St, Sikeston, MO 63801-5043 | 2006-10-26 |
| 1598854945 | Jane E Eaves | Nurse Practitioner | 1013 N Main St, Sikeston, MO 63801-5043 | 2006-10-12 |
| 1588769293 | David W Stroud | Obstetrics & Gynecology | 1013 N Main St, Sikeston, MO 63801-5043 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1992212153 | Sharaye Gilmore | Social Worker | 135 Plaza Dr Suite 102, Sikeston, MO 63801 | 2018-01-09 |
| 1730606385 | Megan Leann Schlosser | Occupational Therapy Assistant | Kenny Rogers Children's Center, 300 Floyd Dr., Sikeston, MO 63801 | 2017-08-24 |
| 1780130930 | Delta South Adult Care Center LLC | Clinic/Center | 640 Colonel George E Day Parkway, Sikeston, MO 63801 | 2016-08-28 |
| 1013236421 | Missouri Delta Medical Center | Clinic/Center | 1013 North Main, Sikeston, MO 63801 | 2010-05-25 |
| 1134361868 | Sikeston Rehab, LLC | Physical Therapy Assistant | 806 S. Kingshighway, Sikeston, MO 63801 | 2009-03-26 |
| 1508066978 | Paula Kaye Beck | Occupational Therapist | 2016 Oklahoma Ave, Sikeston, MO 63801 | 2007-07-23 |
| 1740497551 | James D West | Audiologist | 903 South Kingshighway, Sikeston, MO 63801 | 2007-05-17 |
| 1619190162 | Syed Muhammad Shahab Sayeed | Psychiatry & Neurology | 1008 N Main, Missouri Delta Medical Centre, Sikeston, MO 63801 | 2007-04-11 |
| 1629195607 | Melissa A Stewart | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Dacus, Sikeston, MO 63801 | 2007-03-23 |
| Find all providers in zip 63801 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437440245 | Fallan Nichole Mayabb | Obstetrics & Gynecology | 1013 N Main St, Sikeston, MO 63801-5043 | 2011-04-27 |
| 1588769293 | David W Stroud | Obstetrics & Gynecology | 1013 N Main St, Sikeston, MO 63801-5043 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403334 | Sarah Mai Truong | Obstetrics & Gynecology | 402 N Keene St # Dc570.00, Columbia, MO 65201-6986 | 2020-06-30 |
| 1962049593 | Michael Wayne Mccullough | Obstetrics & Gynecology | 500 N Keene St Ste 400, Columbia, MO 65201-8104 | 2019-12-02 |
| 1144881509 | Stephanie Barata | Obstetrics & Gynecology | 402 N Keene St Ste 402, Columbia, MO 65201-6986 | 2019-06-26 |
| 1447814181 | Obstetrical Associates of St. Luke's, LLC | Obstetrics & Gynecology | 224 S Woods Mill Rd Ste 750s, Chesterfield, MO 63017-3623 | 2019-04-29 |
| 1508328782 | Lauren Marie Rackovan | Obstetrics & Gynecology | 1011 Bowles Ave Ste 215, Fenton, MO 63026-2387 | 2019-04-04 |
| 1144798737 | Frg Rlt Holdings, Inc. | Obstetrics & Gynecology | 1747 Smizer Station Rd Ste 1, Fenton, MO 63026-2784 | 2018-11-13 |
| 1568984367 | Gsh Lab LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 1017b, Saint Louis, MO 63141-8264 | 2017-07-13 |
| 1851825715 | Sydni Fazenbaker Crowell | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2009b, Saint Louis, MO 63141 | 2017-04-18 |
| 1063945517 | Donald R Jones Enterprises, LLC | Obstetrics & Gynecology | 225 Physicians Park Ste 300, Poplar Bluff, MO 63901-3930 | 2017-04-11 |
| 1184157984 | Robert Mcdavid | Obstetrics & Gynecology | 3609 Arbor Ct, Columbia, MO 65201-6542 | 2017-04-07 |
| Find all providers with the same taxonomy | ||||
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| 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.