Provider Demographics
NPI:1619231834
Name:NICOLAS, AMY FRANCES (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:FRANCES
Last Name:NICOLAS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 SOUTH BRUCE STREET
Mailing Address - Street 2:AVARA MARSHALL
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1934
Mailing Address - Country:US
Mailing Address - Phone:507-537-9007
Mailing Address - Fax:507-537-2720
Practice Address - Street 1:300 SOUTH BRUCE STREET
Practice Address - Street 2:AVARA MARSHALL
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1934
Practice Address - Country:US
Practice Address - Phone:507-537-9007
Practice Address - Fax:507-537-2720
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR204842-6163W00000X
MN1087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse