Andra Nicholson
NPI 1093479701 · on the registry since 2021
Practice
- Address
- 1724 W Clarke St
Milwaukee, WI 53206 - Phone
- (414) 763-9892
- Fax
- (414) 763-0531
Registry record
- Primary taxonomy
- Driver
172A00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-12-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin