Individual
DR. KAREN MORI WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-4302
(314) 454-4366
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME130146
FL
2080N0001X
Neonatal-Perinatal Medicine Physician
R7J64
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020809300
—
FL
01
—
R9M1E
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/14/2006
Last updated
10/21/2020
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