| NPI | 1649695685 |
|---|---|
| Former Name | NICHOLE PTACEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2134) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1723548) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R1723548) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2020-09-30 |