Individual
NICOLE TERESA WASYLYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5133
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0663
NH
363A00000X
Physician Assistant
Primary
1848
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2014
Last updated
03/28/2022
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