Doctor Name: | MRS. CAROL CROWELL KICK |
NPI Number: | 1245292671 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 521436 |
Business Practice Address: | 791 S Highway 78 Wylie, TX - 750984004 |
Business Phone Number: | 9724424888 |
Business Fax Number: | 9724290366 |
Mailing Address: | 791 S Highway 78, WYLIE |
State: | TX |
Postal Code: | 750984004 |
Phone Number: | 9724424888 |
Fax Number: | 9724424970 |
NPI Enumeration Date: | 04/03/2006 |
NPI Last Update Date: | 01/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 521436 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |