Individual
CASSIDY MICHELLE WILCKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10 MECHANIC ST, JORDAN, NY 13080-8585
(315) 247-0221
Mailing address
10 MECHANIC ST, JORDAN, NY 13080-8585
(315) 247-0221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
665764-01
NY
Other
Enumeration date
08/07/2022
Last updated
08/07/2022
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