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1780012997
TRAVIS RYAN NICKELSON
WICHITA, KS
NPI
1780012997
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: KS 53-76159)
Enumeration Date
2013-10-24
Last Update Date
2013-10-24
Business Address
Mr. TRAVIS RYAN NICKELSON MSN, APRN
5500 E KELLOGG DR
WICHITA, KS 67218-1607
Phone number: 316-685-2221
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Mailing Address
Mr. TRAVIS RYAN NICKELSON MSN, APRN
13809 W ALDERNY ST
WICHITA, KS 67235-7040
Phone number: 620-727-7537
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