Individual
DR. GINA MARIE KICOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN-CNP
Contact information
Practice address
4235 TUSCARAWAS ST W, CANTON, OH 44708-5424
(234) 203-4232
(330) 266-4386
Mailing address
3721 20TH ST NW, CANTON, OH 44708-2926
(330) 354-7324
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.14603
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087459
—
OH
Enumeration date
06/17/2013
Last updated
07/14/2023
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