IndividualActive
Kelly Nickerson, RN, BSN
NPI 1235969742 · Addiction (Substance Use Disorder) Registered Nurse · Damascus, OR
Provider details
- NPI number
- 1235969742
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) Registered NurseNursing Service Providers
- Credential
- RN, BSN
- Sex
- Female
- Sole proprietor
- No
- License
- 201142980RN (OR)
Specialties & taxonomies
Nursing Service Providers
Practice location
15758 Se Highway 224 Unit 96
Damascus, OR 97089-8410
Phone: (503) 421-8226
Approximate (ZIP-level) locationGet directions
Mailing address
15758 Se Highway 224 Unit 96
Damascus, OR 97089-8410
Registry dates
- Enumerated
- 2024-08-07
- Last updated
- 2024-08-07
- Certified
- 2024-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.