| NPI | 1275943243 |
|---|---|
| Doing Business As | ST NICHOLAS HOSPITAL PROFESSIONAL SERVICES GROUP |
| Entity Type | Organization |
| Authorized Contact | ANDREW BAGNALL CEO 920-459-4705 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2021-12-22 |