Individual
NICOLINE CHOMILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4355 KADY AVE NE, SAINT MICHAEL, MN 55376-8498
(761) 291-5198
Mailing address
4355 KADY AVE NE, SAINT MICHAEL, MN 55376-8498
(763) 291-5198
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1493108
MN
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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