Individual
NICOLE ANN RAICIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 HIGHWAY 78 E, JASPER, AL 35501-8956
(205) 387-4000
Mailing address
3550 GRANDVIEW PKWY APT 223, BIRMINGHAM, AL 35243-1988
(678) 756-1303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.2299
AL
363AM0700X
Medical Physician Assistant
PA.2299
AL
363AS0400X
Surgical Physician Assistant
PA.2299
AL
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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