Individual
BONNIE L NICKASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
414 DOCTORS CT, OSHKOSH, WI 54901-2065
(920) 303-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2902-033
WI
363LF0000X
Family Nurse Practitioner
2902
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36013500
—
WI
Enumeration date
10/01/2006
Last updated
02/14/2024
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