Individual
JOHN W. STICKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
211 SENATOR LN, LAKE CHARLES, LA 70611-5339
(337) 855-3231
Mailing address
211 SENATOR LN, LAKE CHARLES, LA 70611-5339
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP2064
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1392316
—
LA
Enumeration date
02/02/2006
Last updated
04/27/2009
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