Nickele, Glenn A

Nickele, Glenn A is an individual health care provider with primary practice located at 216 S Adams St , Saint Croix Falls WI 54024-9449. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Nickele, Glenn A can be contacted via phone (715) 483-3221.

Contact Information

Primary practice address
216 S Adams St Saint Croix Falls WI 54024-9449
Fax: (715) 483-0507
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 42548 Minnesota
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 32220 Wisconsin

Profile Details

NPI number 1093781452
LBN Legal business name Nickele, Glenn A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Jun 12th, 2024 - about 6 months 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 1093781452 NPPES
Minnesota MEDICAID 468980100

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