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General NPI Number Information
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NPI Number | 1245292671
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Entity Type | Individual
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Provider Name | CAROL CROWELL KICK FNP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 791 S HIGHWAY 78
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City | WYLIE
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State | TX
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Zip | 75098-4004
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Country | US
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Telephone | 972-442-4888
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Fax | 972-429-0366
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Provider Business Mailing Address
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Address Line | 791 S HIGHWAY 78
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City | WYLIE
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State | TX
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Zip | 75098-4004
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Country | US
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Telephone | 972-442-4888
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Fax | 972-442-4970
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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 | 521436
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License Number State | TX
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