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Dr. Michael Tysen Nickle, DO
Family Medicine Physician in Pueblo, Colorado
NPI 1417525601

Michael Tysen Nickle is a Family Medicine Physician based in Pueblo, CO. Michael Tysen Nickle practices in Pueblo, CO and has the professional credentials of DO. The NPI Number for Michael Tysen Nickle is 1417525601 and holds a License No. TL.0009001 (Colorado).

The current practice location address for Michael Tysen Nickle is 902 Lakeview Ave, Pueblo, CO and can be reached out via phone at 719-557-5872 and via fax at 719-557-4780.

Location: 902 Lakeview Ave, Pueblo, CO, 81004-3597
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417525601
Provider Name
Michael Tysen Nickle
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
902 Lakeview Ave, Pueblo, CO, 81004-3597
Phone Number
719-557-5872
Fax Number
719-557-4780
Provider Enumeration Date
06/14/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
902 Lakeview Ave
City
Pueblo
State
Colorado
Zip
81004-3597
Phone Number
719-557-5872
Fax Number
719-557-4780
person
Provider Business Mailing Address Details
Address
902 Lakeview Ave
City
Pueblo
State
Colorado
Zip
81004-3597
Phone Number
719-557-5872
Fax Number
719-557-4780
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
TL.0009001 (Colorado)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
TL.0009001 (Colorado)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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