Individual
SARAH RAE WICKENHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP
Contact information
Practice address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483
(617) 807-0958
Mailing address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483
(617) 807-0958
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016863
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209016863
IL
Other
Enumeration date
11/03/2017
Last updated
03/23/2026
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