Healthcare Provider Details

I. General information

NPI: 1992138747
Provider Name (Legal Business Name): SARAH BETH SCHLICKMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 E RUSHOLME ST STE 3020
DAVENPORT IA
52803
US

IV. Provider business mailing address

1228 E RUSHOLME ST STE 3020
DAVENPORT IA
52803-2467
US

V. Phone/Fax

Practice location:
  • Phone: 563-823-9300
  • Fax: 563-823-9330
Mailing address:
  • Phone: 563-823-9300
  • Fax: 563-823-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA111527
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: