Individual
NICOLE L COLLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S ROSS ST, SNOW HILL, MD 21863-1150
(443) 373-8200
Mailing address
PO BOX 123, SNOW HILL, MD 21863-0123
(443) 373-8200
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
374U00000X
Home Health Aide
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y
SOLE PROPIETOR CODE
—
Enumeration date
10/19/2018
Last updated
10/19/2018
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