Individual
JACQUELYN J WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1888 S 14TH ST, FERNANDINA BEACH, FL 32034-3054
(904) 261-0922
(904) 277-8872
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11004323
FL
363LF0000X
Family Nurse Practitioner
APRN11004323
FL
Other
Enumeration date
02/08/2019
Last updated
03/17/2021
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