Individual
MS. AMARA ANN NICOLAIZANDER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
285 COUNTY ROAD MM, BROOKLYN, WI 53521-9491
(608) 455-1634
Mailing address
285 COUNTY ROAD MM, BROOKLYN, WI 53521-9491
(608) 455-1634
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
88740-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39873200
INDEPENDENT PROVIDER
WI
Enumeration date
04/12/2006
Last updated
07/08/2007
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