Individual
NICOLE RUBY NIEUWSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 W INTERSTATE AVE, BISMARCK, ND 58503-0936
(701) 323-3700
Mailing address
765 W INTERSTATE AVE, BISMARCK, ND 58503-0936
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1875
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1875
—
ND
Enumeration date
08/10/2021
Last updated
08/10/2021
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