Mickiewicz, Nanette M
Mickiewicz, Nanette M is an sole proprietor health care provider with primary practice located at 1555 Soquel Dr , Santa Cruz CA 95065-1705. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Mickiewicz, Nanette M can be contacted via phone (831) 462-7512.Contact Information
Primary practice address
1555 Soquel Dr
Santa Cruz CA 95065-1705
Phone: (831) 462-7512
Fax: (415) 591-2446
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | G646700 | California |
Profile Details
| NPI number | 1558319079 |
|---|---|
| LBN Legal business name | Mickiewicz, Nanette M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 5th, 2006 |
| Last updated | Feb 9th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558319079 | NPPES |
| California | MEDICAID | 00G646700 |
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