Provider Demographics
NPI:1396002176
Name:NICKELBERRY-ALEXANDER, QUIANA SADE (RN)
Entity Type:Individual
Prefix:MRS
First Name:QUIANA
Middle Name:SADE
Last Name:NICKELBERRY-ALEXANDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9562 RAINTREE LN
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-3184
Mailing Address - Country:US
Mailing Address - Phone:504-223-4848
Mailing Address - Fax:
Practice Address - Street 1:9562 RAINTREE LN
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-3184
Practice Address - Country:US
Practice Address - Phone:504-223-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN125095164W00000X, 3747P1801X, 376J00000X, 376K00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide