Individual provider · Type 1 NPI
Andra L. Nicholson Sr.
Driver · Milwaukee, WI
NPI number
1093479701
Active
Practice location
1724 W Clarke St
Milwaukee, WI 53206-2030
Fax (414) 763-0531
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | N242-0126-3466-07 (WI) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1093479701
Andra L. Nicholson Sr.'s National Provider Identifier is 1093479701, issued on Oct 28, 2021. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Milwaukee, WI. The record was last updated on Dec 5, 2023.