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General NPI Number Information
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NPI Number | 1144947524
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Entity Type | Individual
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Provider Name | AMELIA KILLICK DNP, APNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 585 CLAY STREET
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City | CHILTON
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State | WI
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Zip | 53014
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Country | US
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Telephone | 800-000-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1421 W BENT AVE
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City | OSHKOSH
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State | WI
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Zip | 54901-2728
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Country | US
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Telephone | 765-860-3195
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13248-33
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License Number State | WI
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