Individual
PAMELA JEAN NIKSICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12720 BASS LAKE RD, MAPLE GROVE, MN 55369-6307
(763) 559-2861
(763) 559-1338
Mailing address
12720 BASS LAKE RD, MAPLE GROVE, MN 55369-6307
(763) 559-2861
(763) 559-1338
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45836
MN
Other
Enumeration date
12/16/2005
Last updated
06/09/2016
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