Individual
KELLEY AYNNE MCNICOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1401 N CALISPEL ST, SPOKANE, WA 99201-2317
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60759141
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
95033920
CA
Other
Enumeration date
12/22/2016
Last updated
04/25/2024
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