Lisa Nickerson

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

786328 Issued in NY

Practice address

616 E 59TH St # 1
Brooklyn, NY 11234-1302

Phone

(917) 405-2502

NPI assigned

Jun 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1508609629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E 59TH ST # 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112341302",
            "telephone_number": "917-405-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E 59TH ST # 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112341302",
            "telephone_number": "917-405-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "786328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laseanda Nicholson, M.A.
• Marteen Nicholson, LMSW
• Randy Nicholson
• Moishe S Nichtborger, MS ED
• Rozy Nichtborger
• Mary Elizabeth Nickerson, LPN
• Rebekah Nickerson, MS SLP
• Nicki Spice, Inc.
• Nicki Spice, Inc.
• Tricia E Nickie

• Home Health Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Home Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.