Provider Demographics
NPI:1710796941
Name:NICKERSON, JULIANNE CD (MSW)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:CD
Last Name:NICKERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 JOY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6118
Mailing Address - Country:US
Mailing Address - Phone:802-861-2570
Mailing Address - Fax:802-864-1619
Practice Address - Street 1:50 JOY DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6118
Practice Address - Country:US
Practice Address - Phone:802-861-2570
Practice Address - Fax:802-864-1619
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker