Individual
BORIANA ROUSSEVA NIKOLOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
410 N MALACATE ST, AJO, AZ 85321-2253
(520) 387-5651
Mailing address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
(520) 387-6036
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
261942
AZ
Other
Enumeration date
08/26/2021
Last updated
09/18/2024
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