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Individual

DR. PETER ELLIOTT NICOLOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, APNP

Contact information

Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14326-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
14326-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100251117
WI
Enumeration date
08/02/2023
Last updated
02/10/2025
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