Individual
NICHOLE LYNN NYGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
118 1/2 N WALNUT ST, VAN WERT, OH 45891-1719
(419) 238-4387
Mailing address
PO BOX 27, VAN WERT, OH 45891-0027
(419) 238-4387
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
2800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000294842
ANTHEM
OH
Enumeration date
01/22/2007
Last updated
10/16/2007
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