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Individual

NICOLE ROSE SPANIOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
406 W CEDAR ST, BERESFORD, SD 57004-1231
(605) 254-6153
Mailing address
406 W CEDAR ST, BERESFORD, SD 57004-1231
(605) 254-6153

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P010497
SD

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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