Individual
VENINA WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1061 HARMON AVE, BLDG 302, FORT STEWART, GA 31314-5641
(912) 435-6793
Mailing address
1061 HARMON AVE, BLDG 302, FORT STEWART, GA 31314-5641
(912) 435-6793
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9311561
FL
163WA2000X
Administrator Registered Nurse
9311561
FL
163WE0003X
Emergency Registered Nurse
9311561
FL
163WM0102X
Maternal Newborn Registered Nurse
9311561
FL
163WM0705X
Medical-Surgical Registered Nurse
9311561
FL
163WP0200X
Pediatric Registered Nurse
9311561
FL
163WS0200X
School Registered Nurse
9311561
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9311561
RN
FL
Enumeration date
09/04/2014
Last updated
09/04/2014
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