Stickley, Brenda K

Stickley, Brenda K is an sole proprietor health care provider with primary practice located at 610 E Chestnut St , Wauseon OH 43567-1463. She recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as her primary health care specialty. Stickley, Brenda K can be contacted via phone (419) 357-9292.

Contact Information

Primary practice address
610 E Chestnut St Wauseon OH 43567-1463
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 2695463 Ohio

Profile Details

NPI number 1114520046
LBN Legal business name Stickley, Brenda K
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 22nd, 2020
Last updated Nov 22nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114520046 NPPES
Ohio MEDICAID 0180383
Ohio MEDICAID 2695463

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