Individual
JUDITH WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
20306 BADGER LANE, ONLEY, VA 23418
(757) 787-7374
(757) 787-4513
Mailing address
PO BOX 159, ONLEY, VA 23418-0159
(757) 787-7374
(757) 787-4513
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024090481
VA
Other
Enumeration date
01/06/2006
Last updated
08/30/2012
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