Individual
HEATHER LICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
221 W 1ST ST, SAINT FRANCIS, KS 67756-3540
(785) 332-2682
(785) 332-2516
Mailing address
221 W 1ST ST, SAINT FRANCIS, KS 67756-3540
(785) 332-2682
(785) 332-2516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0435055
KS
207Q00000X
Family Medicine Physician
7525
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093026429
BCBS
KS
05
—
30004035620005
—
KS
Enumeration date
06/30/2010
Last updated
05/11/2022
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