Most Relevant Information
Provider Data
| NPI Number: | 1003654468 |
| Provider Name: | NICHOLE MICHELLE BYNUM LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 225776 |
Most Important Dates
| Enumeration Date: | 07/18/2024 |
| Last Updated: | 07/18/2024 |
Provider Practice Location
670 W FIREWEED LN STE 160
ANCHORAGE
AK
995032561
Practice Location Phone/Fax
| Phone: | 9077700862 |
| Fax: |
Provider Mailing Location
601 QUACCO RD UNIT 303
SAVANNAH
GA
314194031
Provider Mailing Phone/Fax
| Phone: | 9126596481 |
| Fax: |