Silloway, Nicole D
Silloway, Nicole D is an individual health care provider with primary practice located at 2165 White Bear Ave N , Maplewood MN 55109-2707. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Silloway, Nicole D can be contacted via phone (651) 523-9800.Contact Information
Primary practice address
2165 White Bear Ave N
Maplewood MN 55109-2707
Phone: (651) 523-9800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 9401 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 9401 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1954 | Wisconsin |
Profile Details
| NPI number | 1386636553 |
|---|---|
| LBN Legal business name | Silloway, Nicole D |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Apr 4th, 2024 - about 2 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 | 1386636553 | NPPES |
| Wisconsin | MEDICAID | 42882500 | |
| Wisconsin | MEDICAID | 729430100 | |
| Wisconsin | Other | 003756125 |
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