NPI 1659965606
Juanita Nickelson
Practice location
- Address
- 2501 McKenna Blvd, Madison, WI 53711-3917
- Phone
- (414) 704-4217
- Mailing address
- 733 Struck St Unit 45617, Madison, WI 53744-3660
Registered specialties
Nursing Home Administrator
Primary
Registry record
- NPI
- 1659965606
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 21 Feb 2021
- Record last updated
- 21 Feb 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.