Individual
MISS NICHOLE RAE BORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
214 14TH AVE SW, SIDNEY, MT 59270-3521
(406) 488-2100
Mailing address
214 14TH AVE SW, SIDNEY, MT 59270-3521
(406) 488-2100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
ATR-LAT-LIC-37
MT
363AS0400X
Surgical Physician Assistant
Primary
91635
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/09/2014
Last updated
01/06/2021
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