Individual
MISS NICHOLE ANGILIC DEGREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1431 WASHINGTON BLVD APT 2306, DETROIT, MI 48226-1728
(414) 630-0379
Mailing address
1431 WASHINGTON BLVD APT 2306, DETROIT, MI 48226-1728
(414) 630-0379
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
309638-31
WI
164W00000X
Licensed Practical Nurse
Primary
4703119998
MI
Other
Enumeration date
03/17/2013
Last updated
12/04/2018
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