Provider Demographics
NPI:1023044740
Name:NYKAMP - NICKLES, CINDY L (DC)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:L
Last Name:NYKAMP - NICKLES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CINDY
Other - Middle Name:L
Other - Last Name:NYKAMP NICKLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC,FIACA
Mailing Address - Street 1:3598 OAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27248-8283
Mailing Address - Country:US
Mailing Address - Phone:336-953-2591
Mailing Address - Fax:336-626-2622
Practice Address - Street 1:3598 OAKLEY RD
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27248-8283
Practice Address - Country:US
Practice Address - Phone:336-953-2591
Practice Address - Fax:336-626-2622
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7908706Medicaid
NC7908706Medicaid
NC244582AMedicare UPIN