JEREMY DON NICKERSON - NPI 1134626211 - Peer Specialist in Grand Island, NE

Q: What is Jeremy Nickerson's NPI number?

The NPI number for Jeremy Nickerson is 1134626211. It was assigned to this individual provider in the NPPES registry on April 6, 2018.

Q: What is Jeremy Nickerson's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Nickerson was last updated on April 6, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jeremy Don Nickerson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY DON NICKERSON (NPI 1134626211) is an individual peer specialist in Grand Island, Nebraska and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1134626211

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameJEREMY DON NICKERSON

Location Address914 BAUMANN DRGrand Island, NE 68803-4401

Mailing Address914 Baumann DrGrand Island, NE 68803-4401 · (308) 385-5250 · Fax (308) 385-5271

Phone(308) 385-5250

Fax(308) 385-5271

Sole ProprietorNo

Enumeration DateApril 6, 2018

✔ NPI 1134626211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

914 BAUMANN DR, Grand Island, NE 68803

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KARA N KLINGINSMITH LMHP

Counselor (Professional)