Individual
ELISHA STICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
19097 BONE RD, MOUNT VERNON, OH 43050-9540
(740) 263-0853
Mailing address
19097 BONE RD, MOUNT VERNON, OH 43050-9540
(740) 263-0853
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
411114
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063056
—
OH
Enumeration date
08/11/2015
Last updated
08/11/2015
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