Individual
STEPHANIE FLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 482-0643
(812) 482-0214
Mailing address
2690 S SAINT ANTHONY RD W, HUNTINGBURG, IN 47542-9542
(812) 630-9654
(812) 326-9410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28153536A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000307828
ANTHEM BC
IN
01
—
28153536A
INDIANA LICENSE
IN
Enumeration date
12/20/2006
Last updated
07/10/2007
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