Individual
NICKLAS LEE RAYCRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 728-4601
Mailing address
671 WHITMAN AVE, HOLLAND, MI 49423-6742
(810) 588-7066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704318829
MI
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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