Individual
NICKOLE ANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Mailing address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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