Wickenden, Deborah Lynn

Wickenden, Deborah Lynn is an individual health care provider with primary practice located at 420 W 4Th St , Mishawaka IN 46544-1948. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wickenden, Deborah Lynn can be contacted via phone (574) 307-7673.

Contact Information

Primary practice address
420 W 4Th St Mishawaka IN 46544-1948
Phone: (574) 307-7673
Fax: (574) 307-7692
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002529A Indiana

Profile Details

NPI number 1225218746
LBN Legal business name Wickenden, Deborah Lynn
Credentials RN,NP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2007
Last updated Mar 29th, 2023 - about 3 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 1225218746 NPPES
Indiana Other 71002529A INDIANA NP LICENSE

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