Penni Nickles, is a
Rehabilitation Practitioner based in Mesquite, Texas. Penni Nickles is licensed to practice in * (Not Available) (license number ) and her current practice location is
5346 Riverport Dr, Mesquite, Texas. She can be reached at her office (for appointments etc.) via phone at
(281) 832-0432.
NPI number for Penni Nickles is 1730097940 and her current mailing address is 5346 Riverport Dr, Mesquite, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1730097940.
Healthcare Provider's Profile
| Full Name | Penni Nickles |
|---|
| Gender | Female |
|---|
| Speciality | Rehabilitation Practitioner |
|---|
| Location | 5346 Riverport Dr, Mesquite, Texas |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1730097940
- Provider Enumeration Date: 08/29/2026
- Last Update Date: 08/29/2026
Medical Identifiers
Medical identifiers for Penni Nickles such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730097940 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
| 225CA2400X | Rehabilitation Counselor - Assistive Technology Practitioner | (* (Not Available)) | Secondary |
| 174H00000X | Health Educator | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Penni Nickles is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Penni Nickles,
5346 Riverport Dr,
Mesquite, TX 75150-1218
Ph: (281) 832-0432 | Penni Nickles,
5346 Riverport Dr,
Mesquite, TX 75150-1218
Ph: (281) 832-0432 |
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