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Contact Information

CHEVONNE M NICKERSON, FNP
130 CENTERWAY
CORNING, NY14830
 Phone: 607-973-8000
 Fax: 607-973-8161
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for CHEVONNE M NICKERSON · (Female)

NPI # 1386616977
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 02/07/2006
Last updated 03/24/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NY License # F331493
  • NY License # F331493-1
  • NY Medicaid 01731906
  • NY Other CC8362 RR MEDICARE GROUP
  • NY Other 500019277 RR MEDICARE PIN
Hospital affiliation(s)
  • CORNING HOSPITAL - (Acute Care)
    176 DENISON PARKWAY EAST
    CORNING, NY 14830
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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