Individual
ANGELA LYNN WICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
21165 LAST CHANCE RIDGE RD, DEADWOOD, SD 57732-7303
(515) 971-5162
Mailing address
21165 LAST CHANCE RIDGE RD, DEADWOOD, SD 57732-7303
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A-095302
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740585603
—
IA
Enumeration date
01/24/2011
Last updated
07/27/2026
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