Individual
MRS. FUSAE MARY WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4560 S EASTERN AVE STE 15, LAS VEGAS, NV 89119-6182
(702) 994-7267
(702) 623-5995
Mailing address
7104 CARMEN BLVD, LAS VEGAS, NV 89128-3430
(702) 994-7267
(702) 623-5995
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
813615
NV
Other
Enumeration date
02/10/2007
Last updated
06/11/2021
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