Individual provider · NPI-1

Dr. Carroll John Nickle, D.O.

Preventive Medicine, Aerospace Medicine · Virginia Beach, VA

NPI number1497757108
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1497757108
Entity type
Individual (NPI-1)
Name
Dr. Carroll John Nickle
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 12, 2005
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083A0100X Preventive Medicine, Aerospace Medicine19464COYes

Practice location

1224 Chattingham Dr
Virginia Beach, VA 23464-5836

Phone 757-495-2719

Mailing address

1224 Chattingham Dr
Virginia Beach, VA 23464-5836

Phone 757-495-2719

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