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Individual

NICOLE D. M. MINIUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, FNP-BC

Contact information

Practice address
123 S MCKINLEY AVE, RENSSELAER, IN 47978-2949
(219) 866-7222
(219) 866-7001
Mailing address
123 S MCKINLEY AVE, RENSSELAER, IN 47978-2949
(219) 866-7222
(219) 866-7001

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041386097
IL
163WG0000X
General Practice Registered Nurse
209011762
IL
163WG0000X
General Practice Registered Nurse
Primary
28192832A
IN

Other

Enumeration date
03/24/2015
Last updated
03/24/2015
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