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General NPI Number Information
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NPI Number | 1912142548
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Entity Type | Individual
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Provider Name | KRISTIN MARIE GICK NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 101 W 61ST AVE
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City | HOBART
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State | IN
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Zip | 46342-6449
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Country | US
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Telephone | 765-423-6224
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Fax | 765-423-6910
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Provider Business Mailing Address
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Address Line | PO BOX 781076 SIGMA MEDICAL GROUP
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City | DETROIT
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State | MI
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Zip | 48278-2099
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN 28120649 A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP 71002804 A
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License Number State | IN
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