| NPI | 1457540379 |
|---|---|
| Former Name | MICHELLE MARIE NICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.006739041.248938) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2015-09-22 |