Individual
MICHELE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
295 TYLER ROAD SOUTH, RED WING, MN 55066-1305
(651) 385-0594
Mailing address
295 TYLER ROAD SOUTH, RED WING, MN 55066
(651) 385-0594
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R5658
SD
Other
Enumeration date
04/17/2009
Last updated
10/04/2011
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