Keely Marie Nickell, is a
Licensed Vocational Nurse based in Breckenridge, Texas. Keely Marie Nickell is licensed to practice in Texas (license number 200919) and her current practice location is
2066 Us Highway 180 E, Breckenridge, Texas. She can be reached at her office (for appointments etc.) via phone at
(254) 246-3950.
NPI number for Keely Marie Nickell is 1497374482 and her current mailing address is 2066 Us Highway 180 E, Breckenridge, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1497374482.
Provider's Profile
| Full Name | Keely Marie Nickell |
|---|
| Gender | Female |
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| Speciality | Licensed Vocational Nurse |
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| Location | 2066 Us Highway 180 E, Breckenridge, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1497374482
- Provider Enumeration Date: 04/10/2020
- Last Update Date: 04/10/2020
Medical Identifiers
Medical identifiers for Keely Marie Nickell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497374482 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164X00000X | Licensed Vocational Nurse | 200919 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keely Marie Nickell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Keely Marie Nickell,
2066 Us Highway 180 E,
Breckenridge, TX 76424-4938
Ph: () - | Keely Marie Nickell,
2066 Us Highway 180 E,
Breckenridge, TX 76424-4938
Ph: (254) 246-3950 |
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