Jessica Nicole Nicklo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

360001 Issued in NY

Practice address

713 Troy Schenectady Rd Ste 224
Latham, NY 12110-2490

Phone

(518) 269-4700

Fax

(518) 944-2560

NPI assigned

Jun 8, 2026

Last updated

Sep 10, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1447183496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 TROY SCHENECTADY RD STE 224",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102490",
            "telephone_number": "518-269-4700",
            "fax_number": "518-944-2560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122033421",
            "country_code": "US",
            "telephone_number": "518-451-7570",
            "fax_number": "518-621-5691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "713 Troy Schenectady Rd Ste 224",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121102490",
            "country_code": "US",
            "telephone_number": "518-269-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKLO",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "360001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP-Payer credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1440 Western Ave",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122033421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "713 Troy Schenectady Rd Ste 224",
            "city": "Latham",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121102490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Jeanette Mannion Ngelezi
• Barbara Nguyen, PA-C
• Samantha Nicchi
• Alexander Ely Nicholson, NPP
• Nancy Lennox Nicholson, PH.D.
• Nicol's Village Vibes, LLC
• Nicolla and Associates, PT & OT Services, PLLC
• Thomas Christopher Nicolla Jr., PT
• Lowry Nicsevic
• Micaela Nordhauser, MD

• Family Nurse Practitioner in Latham, NY
• Providers in Latham, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.