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Individual

NATALIE CHRISTINE LICKTEIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
13101 STATE LINE RD, KANSAS CITY, MO 64145-1650
(816) 942-2438
Mailing address
4022 JOHN BROWN RD, RANTOUL, KS 66079-9145
(785) 241-4018

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011010846
MO
363LF0000X
Family Nurse Practitioner
75268
KS

Other

Enumeration date
04/27/2011
Last updated
08/12/2013
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