Individual
CARRIE ANN LICKLIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
6504 WRENVIEW CT, HUBER HEIGHTS, OH 45424-2731
(937) 825-2127
Mailing address
6504 WRENVIEW CT, HUBER HEIGHTS, OH 45424-2731
(937) 825-2127
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
231814
AZ
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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