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Individual

NICOLE MARIE WANEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, DNP, AGA-CNP BC

Contact information

Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-9213
Mailing address
61815 NORTH AVE, RAY, MI 48096-3324
(443) 433-8425

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
4704293074
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704293074
MI

Other

Enumeration date
01/14/2025
Last updated
03/03/2025
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