Individual
NICOLE LYNN ULRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4670 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-4119
(952) 993-8829
Mailing address
4670 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-4119
(952) 993-8829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54301
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/26/2010
Last updated
05/22/2015
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