Individual
KIMBERLY ANN WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP, PMHNP-BC
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(651) 379-1774
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8424
MN
Other
Enumeration date
08/16/2021
Last updated
03/15/2023
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