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Individual
KELSEY GULLICKSON
Active
Individual
KELSEY GULLICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60904899
WA
363LG0600X
Gerontology Nurse Practitioner
AP60904899
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2141571
—
WA
01
—
AP60904899
WASHINGTON STATE NURSE PRACTITIONER LICENSE
WA
Enumeration date
03/15/2019
Last updated
12/07/2024
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