Individual
BRENTON GICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-I, RN
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
139405
OR
163WE0003X
Emergency Registered Nurse
Primary
201505032
OR
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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