Individual
MRS. JEAN L NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(000) 000-0000
Mailing address
9900 BREN ROAD EAST, MAIL ROUTE MN 008-B213, MINNETONKA, MN 55343
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP03003
OH
Other
Enumeration date
03/08/2006
Last updated
06/28/2020
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