Individual
JENIFFER RACHELLE WICKLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
1265 MAPLEWOOD AVE, LEWISBURG, WV 24901-9478
(304) 645-2700
(304) 645-3188
Mailing address
1265 MAPLEWOOD AVE, LEWISBURG, WV 24901-9478
(304) 645-2700
(304) 645-3188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
106770
WV
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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