Individual
LYNETTA TRICE-BICKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN FNP-BC
Contact information
Practice address
400 N HIGHLAND AVE, AURORA, IL 60506-3814
(000) 123-4567
Mailing address
2405 ESSINGTON RD, SUITE B #64, JOLIET, IL 60435-1204
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018295
IL
Other
Enumeration date
09/29/2018
Last updated
03/24/2024
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