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General NPI Number Information
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NPI Number | 1225974041
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Entity Type | Individual
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Provider Name | LEAH KICK
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Gender | Female
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 618 BAKERTOWN RD
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City | SULLIVAN
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State | WI
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Zip | 53178-9769
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Country | US
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Telephone | 920-675-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 206 S TAFT AVE
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City | JEFFERSON
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State | WI
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Zip | 53549-1453
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Country | US
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Telephone |
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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