Individual
MISTY MORNA NICKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1717 WEST COWELS STREET, FAIRBANKS, AK 99701
(907) 451-6682
(907) 459-3950
Mailing address
1717 WEST COWELS STREET, FAIRBANKS, AK 99701
(907) 451-6682
(907) 459-3950
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6776
AK
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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