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1023617362
NICKOLAS C SOUTHWICK
PLYMOUTH, MN
NPI
1023617362
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MN 2342009)
Enumeration Date
2020-10-19
Last Update Date
2023-11-10
Business Address
NICKOLAS C SOUTHWICK CRNA
14700 28TH AVE N STE 20
PLYMOUTH, MN 55447-4876
Phone number: 763-559-3779
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Mailing Address
NICKOLAS C SOUTHWICK CRNA
PO BOX 47159
PLYMOUTH, MN 55447-0159
Phone number: 763-559-3779
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