Healthcare Provider Details

I. General information

NPI: 1356597397
Provider Name (Legal Business Name): NANCY L SICKELKA AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 03/21/2024
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 - 29TH ST NE STE A
CEDAR RAPIDS IA
52402-3452
US

IV. Provider business mailing address

1825 - 29TH ST NE STE A
CEDAR RAPIDS IA
52402-3452
US

V. Phone/Fax

Practice location:
  • Phone: 319-286-8782
  • Fax: 319-286-8798
Mailing address:
  • Phone: 319-286-8782
  • Fax: 319-286-8798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number309
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number523
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: