Individual
NICOLE MARIE NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 HOSPITAL PL, SOLDOTNA, AK 99669-6999
(907) 714-5831
Mailing address
250 HOSPITAL PL, SOLDOTNA, AK 99669-7559
(907) 714-4502
(907) 714-4696
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
111775
AK
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
42203
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715510
—
AK
Enumeration date
05/02/2007
Last updated
03/15/2021
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