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General NPI Number Information
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NPI Number | 1558172114
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Entity Type | Individual
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Provider Name | ANNA WICKS
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 225 S CENTER AVE
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City | SOMERSET
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State | PA
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Zip | 15501-2033
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Country | US
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Telephone | 814-443-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 840 WOOD ST
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City | CLARION
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State | PA
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Zip | 16214-1240
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 789509
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License Number State | PA
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