Individual
NICOLE PROHASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
133 LAURA DR, ALMA, MI 48801-1998
(989) 854-1195
Mailing address
133 LAURA DR, ALMA, MI 48801-1998
(989) 854-1195
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703099841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703099841
STATE OF MICHIGAN
MI
Enumeration date
11/03/2016
Last updated
11/03/2016
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