Individual
NICOLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5366 386TH ST NE, NORTH BRANCH, MN 55056-5833
(651) 674-8353
Mailing address
9778 PINE SHORES DR, PINE CITY, MN 55063-4575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R1795291
MN
363LA2200X
Adult Health Nurse Practitioner
Primary
AG0614167
MN
Other
Enumeration date
05/14/2014
Last updated
07/03/2014
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