Individual
KELSEY VICTORIA WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1375 NW KINGSTON AVE, BEND, OR 97703-2242
(541) 274-0240
Mailing address
1385 NW FORT CLATSOP ST, BEND, OR 97703-5524
(541) 274-0240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202112796NP-PP
OR
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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