Anderson, Nicole

Anderson, Nicole is an individual health care provider with primary practice located at 1400 W Ice Lake Rd , Iron River MI 49935-9526. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Anderson, Nicole can be contacted via phone (906) 265-6121.

Contact Information

Primary practice address
1400 W Ice Lake Rd Iron River MI 49935-9526
Phone: (906) 265-6121
Fax: (906) 265-2033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601003919 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003919 Michigan

Profile Details

NPI number 1245355049
LBN Legal business name Anderson, Nicole
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245355049 NPPES
Wisconsin MEDICAID 41951600
Wisconsin Other 700C610000

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