Individual
NIGEL WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2638 FRANCIS ST, JACKSON, MI 49203-4617
(517) 581-8084
Mailing address
2638 FRANCIS ST, JACKSON, MI 49203-4617
(517) 581-8084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110249
MI
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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