Individual
TODD NISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
583 S CLARIZZ BLVD, BLOOMINGTON, IN 47401-5515
(812) 333-2663
Mailing address
583 S CLARIZZ BLVD, BLOOMINGTON, IN 47401-5515
(812) 333-2663
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IN
Other
Enumeration date
04/25/2006
Last updated
12/18/2020
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