Individual
MS. EMILY WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3434 W BROADWAY STE 100, COUNCIL BLUFFS, IA 51501-3291
(712) 325-0022
Mailing address
3434 W BROADWAY STE 100, COUNCIL BLUFFS, IA 51501-3291
(712) 325-0022
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
114078
NE
363LP2300X
Primary Care Nurse Practitioner
Primary
A174602
IA
Other
Enumeration date
04/07/2022
Last updated
10/24/2023
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