Individual
ANDRIA MICHELLE NICKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1220 THEIL ST, HARTFORD, WI 53027-1448
(262) 670-6595
Mailing address
333 S MAIN ST, WEST BEND, WI 53095-3341
(217) 316-2971
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19504-40
WI
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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