NICOLE LYNN FATKA

GILMAN, IL
NPI1073048468
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies246Z00000X Specialist/Technologist, Other
Enumeration Date2017-04-24
Last Update Date2017-04-24
Business Address
-- NICOLE LYNN FATKA
318 N THOMAS ST
GILMAN, IL 60938-1352
Phone number: 815-258-1043
Mailing Address
-- NICOLE LYNN FATKA
318 N THOMAS ST
GILMAN, IL 60938-1352
Phone number: