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Individual

NICOLETTE MARLENE DICKERHOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 562-2211
Mailing address
1534 VALE PL, ERIE, CO 80516-4037
(636) 751-5771

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
1628334
CO
363LN0000X
Neonatal Nurse Practitioner
Primary
124870
AK

Other

Enumeration date
06/03/2017
Last updated
10/11/2017
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