Individual
MR. WILLIAM C NICOL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
819 LOWER CONTINENTAL, # 2, RED LODGE, MT 59068-2411
(406) 853-5480
Mailing address
PO BOX 2411, RED LODGE, MT 59068-2411
(406) 853-5480
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12289
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0433953
—
MT
Enumeration date
03/23/2006
Last updated
07/08/2007
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