Individual
NICOLE ANNE TIEASKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43335 KALIFORNSKY BEACH RD STE 25, SOLDOTNA, AK 99669-8280
(479) 530-1029
Mailing address
43335 KALIFORNSKY BEACH RD STE 25, SOLDOTNA, AK 99669-8280
(479) 530-1029
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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