Individual
TRINA NICKSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1830 LAPORTE AVE, FORT COLLINS, CO 80521-2341
(970) 416-6240
(970) 472-2369
Mailing address
1830 LAPORTE AVE, FORT COLLINS, CO 80521-2341
(970) 416-6240
(970) 472-2369
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002024275
CO
124Q00000X
Dental Hygienist
10636-16
WI
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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