Individual
MRS. NICOLE ASHLEY POLAND
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RCS LPN
Contact information
Practice address
519 HANNERVILLE RD, STOUGHTON, WI 53589-4318
(608) 873-2821
Mailing address
643 SHORT ST, FORT ATKINSON, WI 53538-1457
(608) 212-1791
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38340200
—
WI
Enumeration date
05/22/2006
Last updated
07/09/2007
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