National Provider Identifier

Nicole L Knickerbocker, LPN

Nicole L Knickerbocker, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Brockport, NY and a listed phone number of (607) 621-0472.

NPI 1427804863Brockport, NYLicensed Practical Nurse

Profile Overview

NPI
1427804863
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
April 26, 2024
Last Updated
April 26, 2024

Practice Location

  • 183 Main St Apt 3
  • Brockport, NY 14420-2254

Phone: (607) 621-0472

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1427804863
Entity Type
Individual
Last Name
Knickerbocker
First Name
Nicole
Middle Name
L
Name Prefix
MS.
Credential
LPN
Mailing Street Address
183 Main St Apt 3
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-2254
Mailing Country
US
Mailing Phone
(607) 621-0472
Practice Street Address
183 Main St Apt 3
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-2254
Practice Country
US
Practice Phone
(607) 621-0472
Enumeration Date
April 26, 2024
Last Updated
April 26, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
April 26, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)