Individual
MARY ANN NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
6565 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2137
(952) 920-2200
(952) 920-0866
Mailing address
6565 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2137
(952) 920-2200
(952) 920-0866
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R0522737
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237318100
—
MN
Enumeration date
11/21/2005
Last updated
03/07/2016
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