Individual
MRS. LORI MADELINE WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2333 BIDDLE ST, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
22401 STEPPE LN, BROWNSTOWN, MI 48193-8810
(313) 615-2221
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704191121
MI
Other
Enumeration date
06/27/2006
Last updated
10/13/2020
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