NICOLE IRENE BACK

SAINT CLAIR SHORES, 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 Date2024-10-25
Business Address
NICOLE IRENE BACK
22213 LOVE ST
SAINT CLAIR SHORES, MI 48082
Phone number: 734-626-4672
Mailing Address
NICOLE IRENE BACK
22213 LOVE ST
SAINT CLAIR SHORES, MI 48082
Phone number: 734-626-4672