Mr. Andra L Nicholson Sr.
Mr. Andra L Nicholson Sr. is a Driver in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2021.
- Licensed in
- WI
- In the registry since
- 2021
Practice location Address checks out
1724 W Clarke StMilwaukee, WI 53206-2030
Phone: (414) 763-9892
Fax: (414) 763-0531
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence N242-0126-3466-07 (WI) |
|---|
Record details
| NPI number | 1093479701 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 28, 2021 |
| Last updated in NPPES | December 5, 2023 |
| Certification date | December 5, 2023 |
| Mailing address | 1724 W Clarke St, Milwaukee, WI 53206-2030 |
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