person
Mrs. Nicole Therese Manecke, PA
Medical Physician Assistant in Baxter, Minnesota
NPI 1821180712

Nicole Therese Manecke is a Medical Physician Assistant based in Baxter, MN and is specialized in Medical. Nicole Therese Manecke practices in Baxter, MN and has the professional credentials of PA. The NPI Number for Nicole Therese Manecke is 1821180712 and holds a License No. 085-001851 (Minnesota).

The current practice location address for Nicole Therese Manecke is 13359 Isle Dr, Baxter, MN and can be reached out via phone at 218-454-7546 and via fax at 218-454-3062.

Location: 13359 Isle Dr, Baxter, MN, 56425-2222
person
Provider Profile Details
NPI Number
1821180712
Provider Name
Nicole Therese Manecke
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
13359 Isle Dr, Baxter, MN, 56425-2222
Phone Number
218-454-7546
Fax Number
218-454-3062
Provider Enumeration Date
09/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1720269426 01 MN DERMATOLOGY PROFESSIONALS, PA TYPE 2 NPI
institution
Provider Business Practice Location Address Details
Address
13359 Isle Dr
City
State
Zip
56425-2222
Phone Number
218-454-7546
Fax Number
218-454-3062
person
Provider Business Mailing Address Details
Address
13359 Isle Dr
City
State
Zip
56425-2222
Phone Number
218-454-7546
Fax Number
218-454-3062
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085-001851 (Illinois)
Definition
Definition to come...
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