Individual
MR. BRENTT CHARLES VANSICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
138 N DIXON RD, KOKOMO, IN 46901-4154
(765) 236-8282
Mailing address
138 N DIXON RD, KOKOMO, IN 46901-4154
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28191762A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008446A
IN
Other
Enumeration date
07/27/2018
Last updated
03/14/2024
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