Amber Marie Nichols, MS, ATC, PES
Specialist/Technologist, Athletic Trainer in Brockport, NY. Individual provider (NPI-1).
NPI number1124248976
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1124248976
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Amber Marie Nichols
- Credential
- MS, ATC, PES
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 26, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 001224-1 | NY | Yes |
Practice location
92 West AveBrockport, NY 14420-1306
Phone 585-750-0749
Mailing address
65 Peppermint DrRochester, NY 14615-1242
Phone 585-621-9105
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 11 Athletic Trainer providers in Brockport · All 444 providers in Brockport
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