Individual
NICHOLE MICHELLE BYNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
601 QUACCO RD UNIT 303, SAVANNAH, GA 31419-4031
(912) 659-6481
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
225776
AK
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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