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Individual
TRISHA MELISSA WICKMAN
Active
Individual
TRISHA MELISSA WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704210330
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704210330
APRN LICENSE
MI
Enumeration date
08/22/2018
Last updated
08/22/2018
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