National Provider Identifier
Clifford Neil Nickerson III, LPN
Clifford Neil Nickerson III, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Williamsville, NY and a listed phone number of (716) 276-2123.
Profile Overview
- NPI
- 1396344438
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- October 20, 2020
- Last Updated
- October 20, 2020
Practice Location
- 2250 Wehrle Dr
- Williamsville, NY 14221-7034
Phone: (716) 276-2123
Specialties
- Licensed Practical Nurse (164W00000X)
Endpoints
- aveanna.com
Other Url | Williamsville, NY 14221
Full Record
- NPI
- 1396344438
- Entity Type
- Individual
- Last Name
- Nickerson
- First Name
- Clifford
- Middle Name
- Neil
- Name Prefix
- Mr.
- Name Suffix
- III
- Credential
- LPN
- Mailing Street Address
- 2250 Wehrle Dr
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-7034
- Mailing Country
- US
- Mailing Phone
- (716) 276-2123
- Practice Street Address
- 2250 Wehrle Dr
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-7034
- Practice Country
- US
- Practice Phone
- (716) 276-2123
- Enumeration Date
- October 20, 2020
- Last Updated
- October 20, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- October 20, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)
- Other Identifiers
- 331437-1 (NY)