Individual
WENDY ANN NICKOLAUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 4TH AVE N, FERGUS FALLS, MN 56537
(218) 998-3778
(218) 998-3187
Mailing address
24761 HEARTLAND DRIVE, NEVIS, MN 56467
(218) 652-4603
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L056788-6
MN
Other
Enumeration date
12/30/2010
Last updated
12/30/2010
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