Individual
JOAN LESLIE NYCKLEMOE-CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
332 2ND AVE N, WAHPETON, ND 58075-4528
(701) 642-7000
(701) 642-7055
Mailing address
332 2ND AVE N, WAHPETON, ND 58075-4528
(701) 642-7000
(701) 642-7055
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0141
ND
Other
Enumeration date
07/17/2006
Last updated
09/15/2008
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