Individual
JEFFREY P SICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN CRNA
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
539 ALLEN ST, FERNDALE, MI 48220-2444
(989) 798-7177
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704272862
MI
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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