Individual
MRS. NICOLE MICHELLE HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
534 LUELLA AVE, CALUMET CITY, IL 60409-3102
(708) 715-3534
Mailing address
534 LUELLA AVE, CALUMET CITY, IL 60409-3102
(708) 715-3534
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043106314
IL
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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