| Doctor Name: | LORRAINE LOUISE LICK |
| NPI Number: | 1871870816 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 13-74661-112 |
| Business Practice Address: | 242 Brunswick St Old Town, ME - 044681613 |
| Business Phone Number: | 2078276128 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1599, BANGOR |
| State: | ME |
| Postal Code: | 044021599 |
| Phone Number: | 2079455247 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2011 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0200X |
| License Number: | 13-74661-112 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | |