Mickiewicz, Nanette M

Mickiewicz, Nanette M is an sole proprietor health care provider with primary practice located at 1555 Soquel Dr , Santa Cruz CA 95065-1705. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Mickiewicz, Nanette M can be contacted via phone (831) 462-7512.

Contact Information

Primary practice address
1555 Soquel Dr Santa Cruz CA 95065-1705
Phone: (831) 462-7512
Fax: (415) 591-2446
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X G646700 California

Profile Details

NPI number 1558319079
LBN Legal business name Mickiewicz, Nanette M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2006
Last updated Feb 9th, 2012 - about 13 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 1558319079 NPPES
California MEDICAID 00G646700

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