Individual
NICOLE J CHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1599 J ST, GRAND FORKS AFB, ND 58205-6306
(701) 747-5555
Mailing address
1599 J ST, GRAND FORKS AFB, ND 58205-6306
(701) 747-5555
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1317
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253467000
—
MN
01
—
27383
BLUE CROSS/BLUE SHIELD
—
05
—
51268
—
ND
01
—
64-06759
MEDICA
—
01
—
79G99CH
BLUE CROSS/BLUE SHIELD MN
—
01
—
B17461047855
PREFERRED ONE
—
Enumeration date
08/30/2006
Last updated
09/30/2025
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