| Doctor Name: | RHODA L WICKER |
| NPI Number: | 1063411072 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 71000359A |
| Business Practice Address: | 275 W 12th St Suite 103 Peru, IN - 469701638 |
| Business Phone Number: | 7654752316 |
| Business Fax Number: | 7654752359 |
| Mailing Address: | 275 W 12th St, Suite 103 PERU |
| State: | IN |
| Postal Code: | 469701638 |
| Phone Number: | 7654752316 |
| Fax Number: | 7654752359 |
| NPI Enumeration Date: | 07/20/2005 |
| NPI Last Update Date: | 03/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 71000359A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |