NANCY SUSANNE NICKERSON (PT) – Physical Therapist, NPI 1922193200

NANCY SUSANNE NICKERSON (PT) is a healthcare provider. based in Emmett, Idaho. specializing in Physical Therapist. They hold the professional credentials PT. They hold a License No. PT1866 (ID). The NPI Number for NANCY SUSANNE NICKERSON (PT) is 1922193200

Main info

Female
38 Years Of Experience
Accepts Medicare Assignment
Name
NANCY SUSANNE NICKERSON (PT)
NPI
1922193200
Phone
(208) 365-5341
Address
809 S WASHINGTON
Enumeration Date
4 October 2006
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9784991870
Graduation Year
1988 (38 years ago)
PAC ID
5496798829
Group Practice PAC ID
6305932096
Professional Enrollment ID
I20130702000321
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for NANCY SUSANNE NICKERSON (PT)

  • 809, South Washington Avenue, Emmett, Gem County, Idaho, 83617, United States

    EMMETT, ID 83617

    Phone: (208) 365-5341

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83617)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305932096View full group profile
NameSpecialtyState
-MA

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Frequently asked questions

What is the registry number for NANCY SUSANNE NICKERSON (PT)?
The registry entry for NANCY SUSANNE NICKERSON (PT) shows NPI 1922193200.
Quick check: is NANCY SUSANNE NICKERSON (PT) active?
Public NPPES data shows NANCY SUSANNE NICKERSON (PT) with an active NPI status right now.
Which specialty label fits NANCY SUSANNE NICKERSON (PT)?
NPPES ties NANCY SUSANNE NICKERSON (PT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to NANCY SUSANNE NICKERSON (PT)?
NANCY SUSANNE NICKERSON (PT) is associated with Emmett, Idaho in the same public data insurers reference.
Who maintains NANCY SUSANNE NICKERSON (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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