Most Relevant Information
Provider Data
| NPI Number: | 1003530221 |
| Provider Name: | NICOLE SANNE |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/30/2022 |
| Last Updated: | 09/30/2022 |
Provider Practice Location
501 IOWA ST
CLEARWATER
NE
687265380
Practice Location Phone/Fax
| Phone: | 4024852061 |
| Fax: |
Provider Mailing Location
PO BOX 8
CLEARWATER
NE
687260008
Provider Mailing Phone/Fax
| Phone: | 4024852061 |
| Fax: |