Provider Demographics
NPI:1255524633
Name:SVIHEL, NICOLE D (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:SVIHEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:2600 65TH AVENUE
Mailing Address - City:OSCEOLA
Mailing Address - State:WI
Mailing Address - Zip Code:54020-3024
Mailing Address - Country:US
Mailing Address - Phone:715-294-2111
Mailing Address - Fax:715-294-2111
Practice Address - Street 1:2600 65TH AVENUE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:WI
Practice Address - Zip Code:54020-3024
Practice Address - Country:US
Practice Address - Phone:715-294-2111
Practice Address - Fax:715-294-5758
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2191023363AM0700X
WI34072363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical