Karen Gail Nickels, LPN, LMT
Individual provider Active NPI Massage Therapist · Cookson, OK
NPI 1033722145 · NPPES record last updated Aug 28, 2020
Key facts
- NPI
- 1033722145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 102510 (OK)
- Practice address
- 29408 S 548 Rd
Cookson, OK 74427-2423 - Phone
- (918) 630-2342
- NPI assigned
- Aug 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70432 | OK | MD | Licensed Practical Nurse |
| 102510 | OK | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 70432 | OK | |
| Massage Therapist | 225700000X | 102510 | OK | Yes |
Addresses
Primary practice location
29408 S 548 Rd
Cookson, OK 74427-2423
Mailing address
29408 S 548 Rd
Cookson, OK 74427-2423
Phone (918) 630-2342
Other providers in Cookson, OK
- Ronald David Brown
- Wendi Esposito-Worthington
- Ezpzhealing LLC
- Green Medical Clinic
- Rance Head
- Charla Nofire
- Winston Perkins
- Robert E. Sanders
All providers in Cookson, OK · Massage Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.