# KIM SICKELS NURSE PRACTITIONER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447469580
- **Authorized official:** KIM ANNETTE SICKELS NURSE PRACTITIONER (NURSE PRACTITIONER)
- **Authorized official phone:** (502) 939-9754

## Contact information

- **Practice address:** 3103 HERITAGE HEIGHTS WAY, JEFFERSONVILLE, IN 47130-8934
- **Practice address phone:** (502) 939-9754
- **Practice address fax:** (812) 284-6550
- **Mailing address:** 3103 HERITAGE HEIGHTS WAY, JEFFERSONVILLE, IN 47130-8934
- **Mailing address phone:** (502) 939-9754
- **Mailing address fax:** (812) 284-6550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 4488P | KY | — |
| 363LA2200X | Adult Health Nurse Practitioner | 71000724A | IN | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 12/05/2007