NICOLE IRENE BACK

WATERFORD, MI
NPI1013756576
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MI  4704247636)
Additional Taxonomies163W00000X Registered Nurse
(Licence: MI  4704247636)
Enumeration Date2024-05-23
Last Update Date2025-03-06
Business Address
NICOLE IRENE BACK
5758 COOLEY LAKE RD
WATERFORD, MI 48327-3073
Phone number: 855-466-3631
Mailing Address
NICOLE IRENE BACK
5758 COOLEY LAKE RD
WATERFORD, MI 48327-3073
Phone number: 855-466-3631