Individual
NICOLE GROENEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
112 6TH AVE N, ELLENDALE, ND 58436-7297
(385) 285-2452
Mailing address
112 6TH AVE N, ELLENDALE, ND 58436-7297
(385) 285-2452
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
9498180-3101
UT
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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