Individual
NICOLE LARAE WENTLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3821 4TH AVE E, HIBBING, MN 55746-2926
(218) 263-9109
Mailing address
3821 4TH AVE E, HIBBING, MN 55746-2926
(218) 263-9109
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R184550-7
MN
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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