Individual
NICOLE TERESE CREIGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
325 WILSON AVE, WAUKESHA, WI 53186-6103
(414) 861-1723
Mailing address
325 WILSON AVE, WAUKESHA, WI 53186-6103
(414) 861-1723
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
138378-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35025300
—
WI
Enumeration date
12/16/2009
Last updated
12/16/2009
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