Individual
NICOLE MARIE HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6545 13 MILE RD NE, ROCKFORD, MI 49341-9714
(616) 866-9393
Mailing address
1052 VETO ST NW, GRAND RAPIDS, MI 49504-5402
(616) 477-2866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703094291
MI
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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