| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MADISON HALEY NICKSIC | 1609602275 | 2024-10-13 |
Madison Haley Nicksic is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1609602275. Registration indicates Madison Haley Nicksic is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Mrs. Madison Haley Nicksic FNP-BC |
| Practice Office Address | 701 GROVE RD GREENVILLE, SC US |
| Practice Office Telephone | 4237544691 |
| Mailing Address | 56 POINTE CIR GREENVILLE, SC 296153506 US |
| Business Telephone | 8647578500 |
| Code | Practice | License No State |
|---|---|---|
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 267813
SC |