Wicks, Beverly

Wicks, Beverly is an individual health care provider with primary practice located at 111 Granada Ct , Orlando FL 32803-3802. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Wicks, Beverly can be contacted via phone (407) 420-1771.

Contact Information

Primary practice address
111 Granada Ct Orlando FL 32803-3802
Phone: (407) 420-1771
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP421302 Florida

Profile Details

NPI number 1154310324
LBN Legal business name Wicks, Beverly
Credentials ARNO
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2005
Last updated Nov 17th, 2008 - about 18 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 1154310324 NPPES
Florida MEDICAID E3026B

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