Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Traci Lynn Nickelson, CNP-BC

Individual provider Family Nurse Practitioner · NPI 1831624956

Mrs. Traci Lynn Nickelson, CNP-BC is a Nurse Practitioner in Chantilly, Virginia. Qualified in 2015, 11 years ago. Practices with Complexcare Medical Group Midwest H PLLC, a 127-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
11
Licensed in
OH
In the registry since
2017
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

14121 Parke Long Ct Ste 201
Chantilly, VA 20151-1647
Phone: (855) 247-1940
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.020218 (OH)

Record details

NPI number1831624956
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP-BC
Sole proprietorYes
NPI enumeratedApril 26, 2017
Last updated in NPPESApril 26, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Complexcare Medical Group Midwest H Pllc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Chantilly