Nicole M Hicks P.A.

NPI 1053349829 - Physician Assistant - 363A00000X

NPI Details
NPI 1053349829
Gender Female
Enumeration Date 06/29/2006
Last Updated 03/12/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
560 S MAPLE ST
SUITE 200
WACONIA MN, 55387-1733, US
Phone (952) 442-2163
Fax (952) 442-5903
Business Location
4200 DAHLBERG DR
SUITE 300
GOLDEN VALLEY MN, 55422-4840, US
Phone (952) 512-5637
Fax (952) 345-7707
Toxanomy
Taxonomy Code 363A00000X
License State Minnesota
License Number 9245
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According to our database, Nicole M Hicks P.A. NPI is 1053349829, taxonomy code is 363A00000X and license number is 9245, license state is located at Minnesota. Nicole M Hicks P.A. physically located at 560 S Maple St, Waconia MN, 55387-1733. NPI Number Nicole M Hicks P.A. has the Individual type.

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1053349829 NPI number is provided on an as is basis without warranty of any kind. 1053349829 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole M Hicks P.A. are for informational purposes only.