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1972728558
DIANA LEE NICOLAISEN
GLEN BURNIE, MD
NPI
1972728558
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WC1500X Registered Nurse, Community Health
(Licence: MD ro85571)
Enumeration Date
2007-04-17
Last Update Date
2007-07-08
Business Address
Mrs. DIANA LEE NICOLAISEN rn
791 AQUAHART RD SUITE 200
GLEN BURNIE, MD 21061-3961
Phone number: 410-222-6625
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Mailing Address
Mrs. DIANA LEE NICOLAISEN rn
791 AQUAHART RD SUITE 200
GLEN BURNIE, MD 21061-3961
Phone number: 410-222-6625
Copy
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