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Individual

KAROL G NIMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106
(505) 841-1819
(505) 841-1998
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4034

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
99-PA27
NM
363A00000X
Physician Assistant
Primary
PA.0005394
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
NM
Enumeration date
05/16/2006
Last updated
06/07/2018
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