Individual
ASHLEY MORRIS WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2191 9TH AVE N, SUITE 200, ST PETERSBURG, FL 33713-7146
(727) 327-0990
(727) 327-0895
Mailing address
2191 9TH AVE N, STE 235, ST PETERSBURG, FL 33713-7152
(813) 977-0733
(813) 971-2230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106183
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9106183
STATE LICENSE
FL
Enumeration date
11/11/2011
Last updated
09/01/2020
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