Individual
NICOLE KANOMATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1465 E PARKDALE AVE, MANISTEE, MI 49660-9709
(231) 876-6421
(231) 876-6430
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2386
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F10220404
MI
Other
Enumeration date
09/26/2022
Last updated
01/15/2025
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