Individual
NICKI DOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4609 GRAPE RD, MISHAWAKA, IN 46545-2649
(574) 220-7885
(317) 967-2229
Mailing address
4609 GRAPE RD, MISHAWAKA, IN 46545-2649
(574) 220-7885
(317) 967-2229
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
24017411
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300095694
—
IN
Enumeration date
11/25/2024
Last updated
11/25/2024
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