Individual
NICCIA M TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2770 CARPENTER RD, STE 200, ANN ARBOR, MI 48108-4104
(734) 971-6000
(734) 971-1026
Mailing address
28786 GLENWOOD, FLAT ROCK, MI 48134-9699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704369544
MI
164W00000X
Licensed Practical Nurse
4703110124
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114014529
—
MI
Enumeration date
04/20/2016
Last updated
04/26/2021
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