| Doctor Name: | NATALIE CHRISTINE LICKTEIG |
| NPI Number: | 1003107830 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 75268 |
| Business Practice Address: | 13101 State Line Rd Kansas City, MO - 641451650 |
| Business Phone Number: | 8169422438 |
| Business Fax Number: | |
| Mailing Address: | 4022 John Brown Rd, RANTOUL |
| State: | KS |
| Postal Code: | 660799145 |
| Phone Number: | 7852414018 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2011 |
| NPI Last Update Date: | 08/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 75268 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |