Individual
NIKOLA MARIE NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1760 MCCULLOCH BLVD N, STE 100, LAKE HAVASU CITY, AZ 86403-6559
(928) 854-5368
(928) 854-4462
Mailing address
1760 MCCULLOCH BLVD N, STE 100, LAKE HAVASU CITY, AZ 86403-6559
(928) 854-5368
(928) 854-4462
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8722
AZ
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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