Individual
STACEY M. KRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
(260) 458-3831
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002854A
IN
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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