NPI
Kelly L Nickelson
NPI 1871780155
Read from the NPPES registry on October 25, 2026.
Facts
- Status
- Active
- Credential
- Physical Therapist
- Type
- Individual
- Enumeration date
- 2007-10-01
- Last updated
- 2023-04-19
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Specialties
Licenses
- License MO
- 2002015010
Location
- Practice location
- 401 Gaylord Dr
- City
- Fulton MO
- Postal code
- 65251-2517
- Phone
- (573) 642-8541
- Fax
- (573) 642-8500
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Physical Therapists in Fulton, MO. 15 with this primary taxonomy in the public file.
Other NPIs in Fulton, MO. 376 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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