Individual
AMANDA L WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 S WASHINGTON ST, EAST PRAIRIE, MO 63845-1526
(573) 649-9411
(573) 649-9442
Mailing address
106 S WASHINGTON ST, EAST PRAIRIE, MO 63845-1526
(573) 649-9411
(573) 649-9442
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2003028629
MO
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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